基于机器学习的预测,使用临床数据来预测患有类风湿性关节炎的患者对Janus激酶抑制剂的反应
Yeo-Jin Lee1, Gyucheol Choi2, Joongyeub Yeo3
1Department of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Frontiers in immunology
|December 12, 2025
概括
机器学习模型准确地预测了类风湿性关节炎 (RA) 患者对氏激酶 (JAK) 抑制剂的反应. 这种个性化的方法可以改善RA患者的治疗选择和临床结果.
科学领域:
- 类风湿病学 类风湿病学
- 人工智能的人工智能
- 药物基因组学 药物基因组学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性炎症状况,治疗反应变化.
- 许多中度至重度RA患者在当前的治疗方法下无法实现缓解.
- 需要个性化治疗策略来优化RA患者的治疗结果.
研究的目的:
- 开发和验证机器学习 (ML) 模型,用于预测中度至重度RA患者对Janus激酶 (JAK) 抑制剂的治疗反应.
- 确定基线临床关键因素,预测对特定的JAK抑制剂 (托法西提尼布和巴里西提尼布) 的反应.
- 评估ML引导治疗选择的潜力,以改善患者的治疗结果.
主要方法:
- 从韩国风湿病学院生物治疗药物 (KOBIO) 登记册和阿桑医疗中心回顾性数据收集.
- 使用基线共变量的渐变增强机器学习模型 (XGBoost) 的培训和验证.
- 使用分层分离的独立培训和测试数据集来预测6个月的低疾病活性或缓解.
主要成果:
- 这项研究包括264名中度至重度RA患者;247人接受了托法西提尼布或巴里西提尼布.
- 6个月后,65% (托法西提尼布) 和70% (巴里西提尼布) 的患者实现了低疾病活性或缓解.
- ML模型显示出高预测性能 (托法西替尼:ROC-AUC 0.82,准确率为80%;巴里西替尼:ROC-AUC 0.88,准确率为88%).
- 关键预测因素包括总胆固醇,CRP,关节胀/疼痛,患者的整体评估和氧化联合使用.
结论:
- 机器学习模型可以准确地预测RA中JAK抑制剂的治疗反应.
- 这些模型可以帮助 RA 患者选择个性化的治疗方法.
- 以模型为指导的治疗选择可能会改善显著比例的患者的治疗结果.
相关概念视频
01:20The JAK-STAT Signaling Pathway
11.8K
Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as SH2...
11.8K
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
445
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
445
01:21Rheumatic Heart Disease III: Medical Management
264
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
264
01:11Genome-wide Association Studies-GWAS
15.2K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
15.2K
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
443
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
443
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
459
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
459