Treatment for the Individual

Computers may soon predict patients' responses to rheumatoid arthritis treatments

(RxWiki News) Seeing that many rheumatoid arthritis patients don't respond to the leading treatments, researchers found a new way to predict how different patients can be treated.

About one-third of rheumatoid arthritis patients do not respond to anti-TNF drugs (the drugs that fight the inflammatory response that causes rheumatoid arthritis). In light of this, researchers wanted to find new drug targets hidden in the DNA of patients.

dailyRx Insight: 30% of rheumatoid arthritis patients do not respond to anti-TNF drugs.

In order to do so, researchers from GNS Healthcare, Inc. and Biogen Idec developed an experimental method to predict individual patients' responses to both existing and new treatments. After collecting information about patients' genetic makeup and symptoms (such as tender and swollen joints), the researchers used a complex computing method (called reverse-engineering and forward simulation) to make sense of the patient data.

With the calculated data, the researchers ran simulated clinical trials. They were able to predict not only how patients would respond to current drug treatments, but also how patients would respond to new and different drug targets in the DNA of patients.

According to Colin Hill, CEO and co-founder of GNS Healthcare, this project showed that researchers can run a small, virtual clinical trial in order to learn more about the biology of a disease (not just rheumatoid arthritis) and the potential genetic targets to treat that disease--if the researchers have access to a supercomputer. With this new computing method, researchers may soon be able to predict individual patients' responses to certain treatments as well as their outcomes.

The hope is that this will improve quality of care as researchers and doctors have more information they can use to make the best possible decisions for patients.

There are approximately 1.3 million rheumatoid arthritis sufferers in the United States, about 75 percent of whom are women. Rheumatoid arthritis damages the joints, most commonly in the hands, feet, and cervical spine. Inflammation can also affects other organs and systems in the body such as the skin, lungs (fibrosis), kidneys (amyloid protein deposits), and cardiovascular system (increased risk for heart attack and stroke, as well as fibrosis and pericarditis). A clinical diagnosis can be made on the basis of symptoms, physical exam, radiographs, x-rays and lab tests. There are many prescription medications used to treat rheumatoid arthritis such as hydroxychloroquine (Plaquenil®), chloroquine (Aralen®), leflunomide (Arava®), and methotrexate (Rheumatrex ®). Non-pharmacological treatment includes psychical therapy, orthoses, and nutritional therapy but these do not stop progression of joint destruction. Analgesia (painkillers) and anti-inflammatory drugs, including steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage. Recently the newer group of biologics, such as abatacept (Orencia®), adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®), and rituximab (Rituxan®) have increased treatment options.

The results of this study are published in the journal PLoS Computational Biology

Review Date: 
March 14, 2011