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Farutin, Victor; Prod'homme, Thomas; McConnell, Kevin; Washburn, Nathaniel; Halvey, Patrick; Etzel, Carol J; Guess, Jamey; Duffner, Jay; Getchell, Kristen; Meccariello, Robin; Gutierrez, Bryan; Honan, Christopher; Zhao, Ganlin; Cilfone, Nicholas A; Gunay, Nur Sibel; Hillson, Jan L; DeLuca, David S; Saunders, Katherine C; Pappas, Dimitrios A; Greenberg, Jeffrey D; Kremer, Joel M; Manning, Anthony M; Ling, Leona E; Capila, Ishan
Arthritis research & therapy, 10/2019, Volume: 21, Issue: 1Journal Article
The goal of this study is to use comprehensive molecular profiling to characterize clinical response to anti-TNF therapy in a real-world setting and identify reproducible markers differentiating good responders and non-responders in rheumatoid arthritis (RA). Whole-blood mRNA, plasma proteins, and glycopeptides were measured in two cohorts of biologic-naïve RA patients (n = 40 and n = 36) from the Corrona CERTAIN (Comparative Effectiveness Registry to study Therapies for Arthritis and Inflammatory coNditions) registry at baseline and after 3 months of anti-TNF treatment. Response to treatment was categorized by EULAR criteria. A cell type-specific data analysis was conducted to evaluate the involvement of the most common immune cell sub-populations. Findings concordant between the two cohorts were further assessed for reproducibility using selected NCBI-GEO datasets and clinical laboratory measurements available in the CERTAIN database. A treatment-related signature suggesting a reduction in neutrophils, independent of the status of response, was indicated by a high level of correlation (ρ = 0.62; p < 0.01) between the two cohorts. A baseline, response signature of increased innate cell types in responders compared to increased adaptive cell types in non-responders was identified in both cohorts. This result was further assessed by applying the cell type-specific analysis to five other publicly available RA datasets. Evaluation of the neutrophil-to-lymphocyte ratio at baseline in the remaining patients (n = 1962) from the CERTAIN database confirmed the observation (odds ratio of good/moderate response = 1.20 95% CI = 1.03-1.41, p = 0.02). Differences in innate/adaptive immune cell type composition at baseline may be a major contributor to response to anti-TNF treatment within the first 3 months of therapy.
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