Can Efficacy of Rheumatoid Arthritis Medications Be Predicted?

Finding treatments for rheumatoid arthritis has proven to be a challenge in the medical community but researchers have found a potential way to help predict whether a medication will be effective in this patient population.

According to study results published in PLOS1, researchers studying the benefits of tocilizumab (TCZ) and infliximab (IFX) found a connection between the former and levels of osteopontin, which could help direct which patients will benefit most from this option. The study noted that the results related to biologic-naïve patients in particular.

Over the course of the study patients were treated with either infliximab or tocilizumab starting in February of 2010 and were studied for at least a year until April of 2013. The patients were studied for several factors including disease duration, and doses of prednisone and methotrexate among others. There were 67 patients in the infliximab group and 70 in the tocilizumab group with all being of Japanese descent.

Looking at the two medications the researchers noted “no significant differences in the baseline characteristics except for methotrexate use between the groups.” They did however note low baseline osteopontin levels as a predictor of clinical disease activity index for the tocilizumab group.

Over the course of the study 7 patients in the infliximab group withdrew from the study for a variety of reasons including pneumonia, a reaction to the infusion, or “improvement of symptoms.” Three patients withdrew from the tocilizumab group “because of inefficacy,” and moving.

While not a definitive treatment direction the authors noted that as a single-center study, “Our study demonstrated that low serum OPN levels predict clinical remission after 1-year TC treatment but not IFX treatment.” They added, “Our prediction model provided insights into how to optimize the choice of biologics and warrants external validation in other cohorts.”