Predicting Response to Infliximab in Rheumatoid Arthritis
Author Information
Author(s): Wijbrandts C A, Dijkgraaf M G W, Kraan M C, Vinkenoog M, Smeets T J, Dinant H, Vos K, Lems W F, Wolbink G J, Sijpkens D, Dijkmans B A C, Tak P P
Primary Institution: Academic Medical Center/University of Amsterdam
Hypothesis
The heterogeneous clinical response to TNFα blocking therapy in rheumatoid arthritis can be predicted by TNFα expression in the synovium before treatment.
Conclusion
The clinical response to TNFα blockade is partly dependent on synovial TNFα expression and the presence of TNFα producing inflammatory cells.
Supporting Evidence
- Higher TNFα expression in the synovial sublining was found in responders compared to non-responders.
- The number of macrophages and T cells was significantly higher in responders.
- TNFα expression was confirmed as a significant predictor of response to therapy.
Takeaway
Doctors can better understand how well a treatment will work for rheumatoid arthritis patients by looking at certain proteins in their joint tissue before starting the treatment.
Methodology
Synovial tissue biopsies were taken from patients before infliximab treatment, and clinical response was evaluated using the 28-joint Disease Activity Score at week 16.
Limitations
The predictive value of synovial TNF expression is statistically significant but overall limited, indicating other factors are also involved.
Participant Demographics
Predominantly female (74%), mean age 55 years, mean disease duration 125 months, 71% rheumatoid factor positive.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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