Novel Autoantibody Biomarkers Can Help Predict Response to RA Therapy

June 12, 2020

By Eric Ramos

CHICAGO -- June 11, 2020 -- A set of antibody biomarkers can help predict which patients with rheumatoid arthritis (RA) will respond to therapy, according to a study presented at the 2020 Virtual Meeting of the European League Against Rheumatism (EULAR).

“For rheumatoid arthritis, many treatments are currently available but each treatment will only induce disease remission in a subset of patients,” said said Patrick Vandormael, MD, Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium. “Moreover, finding out which patients respond well to first-line therapy with classical synthetic disease modifying anti-rheumatic drugs still largely depends on trial and error.”

“We have identified a set of 3 antibody biomarkers that can predict failure of early disease remission after first-line RA therapy, which might contribute to personalised medicine decisions,” he said.

For the study, the researchers collected serum samples from patients with RA with a disease activity severity (DAS-CRP) score

A cDNA phage display library, representing the antigens from RA synovial tissue, was constructed and screened for antibody reactivity in baseline serum samples of patients that failed to reach remission at week 16 (n = 40) and those who did (n = 50). Antigenic targets that showed increased antibody reactivity in pools from patients that did not reach disease remission, were further validated in individual serum samples of 69 patients with RA that did not reach DAS-CRP remission at week 16 and 122 patients with RA who did.

“Screening and validation of antibody reactivity resulted in 41 novel antigens,” the authors reported. “A panel of 3 of these peptide antigens could be composed, whose baseline antibody reactivity correlated with lack of therapy response at week 16.”

Of the patients with RA who did not reach DAS-CRP remission, 43% had presence of antibodies against at least 1 of the 3 antigens compared with 29% of patients who did reach remission (P = .041). A higher proportion of patients with at least 1 of the 3 antigens also failed to reach ACR70 at week 16 (42 vs 26%; P = .029).

[Presentation title: Novel Autoantibody Biomarkers for the Prediction of Therapy Response in Rheumatoid Arthritis. Abstract FRI0596]