Forget personalised medicine and focus on abating disease activity

Area of Science:

• Rheumatology
• Immunology
• Pharmacology

Background:

• Rheumatoid arthritis (RA) treatment involves various biological therapies targeting distinct molecules or cells.
• Patient populations receiving these therapies often exhibit overlapping characteristics.
• Current understanding suggests potential similarities in the efficacy of different biological treatments for RA.

Purpose of the Study:

• To evaluate the evidence for similar efficacy among different biological therapies in rheumatoid arthritis.
• To assess the utility of current biomarkers in predicting treatment response beyond clinical disease activity.
• To propose future research directions for identifying effective biomarkers in RA.

Main Methods:

• Review and synthesis of three distinct lines of evidence regarding biological therapies in RA.
• Analysis of the predictive value of individual and combined biomarkers against clinical disease activity measures.
• Discussion of the implications for clinical practice and future research design.

Main Results:

• Evidence suggests that current biological therapies for rheumatoid arthritis possess similar efficacy.
• These therapies appear to target comparable patient populations, irrespective of the specific molecule or cell targeted.
• Existing biomarkers, individually or in sets, do not provide predictive information beyond clinical disease activity assessments.

Conclusions:

• Differences in patient response to biological therapies may not be attributable to distinct biological effects of the treatments.
• Clinical disease activity assessment remains the primary tool for guiding treatment decisions in rheumatoid arthritis.
• Novel research designs are imperative for the discovery of clinically relevant biomarkers for RA.