Getting Past Trial-and-Error and Rheumatoid Arthritis Pain Treatment

New Approach to Patient Evaluation may Inform Precise Medication Selection

An innovative approach to patient evaluation may offer a significant improvement in the treatment of rheumatoid arthritis, according to researchers from Northwestern University Feinberg School of Medicine. The team believes that genetic profiling of joint tissue can enable better matching of specific patients to specific medications, offering vastly improved outcomes for more rheumatoid arthritis sufferers. Senior author Harris Perlman, PhD, chief of rheumatology at Northwestern, noted, “We have so many different biologic drugs and there’s no rhyme or reason to give one drug versus the other. We waste $2.5 billion a year in ineffective therapy. And patients go through 12 weeks of therapy, don’t respond and get upset.” The work thus far in developing a “precision medicine” approach to rheumatoid arthritis treatment appeared as an uncorrected proof in Arthritis and Rheumatology, and will be officially published later this spring.

Unlike the conventional technique of using blood samples to evaluate medication effectiveness, the Northwestern researchers used ultrasound guidance to take tissue biopsies of the diseased joint. Dr. Perlman commented: “Why go anywhere else? In rheumatoid arthritis, we’ve never gone to the target organ.” The study analyzed biopsied tissue in 41 patients with rheumatoid arthritis, seeking to categorize them according to the genes being produced by their macrophages, the cells that secrete inflammatory, joint destroying proteins in rheumatoid arthritis. The objective is to match specific gene sequences to biologic therapies that seem to be working. Dr. Perlman continued: “The idea is to develop gene sequences to predict whether a patient will respond or not. Our goal is that this procedure will become the standard of care of for all patients with rheumatoid arthritis.”

Read more about the research objectives and accomplishments.

The journal abstract may be read here.

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