Background/Purpose: Patients with Rheumatoid arthritis (RA) have a variety of therapeutic options however tools to predict individual patients’ response are limited. The purpose of this study is to evaluate the ability of a Genefron diagnostic kit to predict RA patient response to TNF α blockers or rituximab

Methods:

Sixteen RA patients were assessed before starting a biologic agent: TNFα blockers (n=10) or rituximab (n= 6). Patients were re-evaluated 3 months after starting treatment. Assessment included swollen joint count (SJC), tender joint count (TJC), patient assessment of disease activity and pain by VAS, physician assessment of disease activity by VAS and health assessment questionnaire (HAQ). Genefron personal diagnostic kits measure the expression level of selected genes (IFN related genes, ubiquitin, genes activating the innate system) by quantitative real time PCR (qRT PCR) aiming to predict treatment outcome for each patient. Blood samples were obtained from each patient before administration of the biologic agent (T₀) and 20-24 hours later (T₂₄). RNA was extracted from PBMC samples and cDNA was transcribed from the RNA samples by high capacity cDNA reverse transcription. qRT PCR results were obtained using selected gene probes. 

Results:

The TNFα blocker group included 9 females/1 male with a median age of 62±10 years and a disease duration of 9.5±16.2 years. A significant decrease in disease activity was observed after 3 months of treatment. Five patients achieved an ACR 20 response. Mean DAS 28 decreased from 5.6±0.9 to 4.3±1.4. The Genefron diagnostic kit predicted the response in 9 of 10 patients, resulting in a prediction accuracy of 90%, sensitivity of 75% and specificity of 100%. The rituximab group included 5 females/1male with a median age of 68±9.3 years and a disease duration of 9±8.5 years. Three patients achieved an ACR 20 response. The Genefron diagnostic kit predicted the response correctly in all 6 patients. 

Conclusion:

In this small group of patients, the Genefron diagnostic kit  predicted the response to TNFα blockers and rituximab in a high percentage of patients. These preliminary results require further confirmation in large scale studies to assess whether this kit may possibly aid in the selection of a suitable biological drug for the individual RA patient.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/expression-levels-of-selected-genes-may-predict-response-to-tnf-alpha-blockers-or-rituximab-in-the-individual-rheumatoid-arthritis-patient/