Rheumatoid arthritis is a chronic autoimmune joint disease caused by the body’s immune system mistakenly attacking the body’s own joints. Rheumatoid arthritis is characterized by inflammation at the lining of the joints, causing painful swelling which can eventually result in bone erosions and joint deformity, if left untreated. The disease can also cause damage to a wide variety of other body systems, including lungs, skin, eyes, heart, blood vessels and others.
How many have Rheumatoid Arthritis?
Rheumatoid arthritis is the most common autoimmune inflammatory joint disease, affecting approximately 0.5% of the population. Women are about two to three times more likely to get RA than men, but risk factors also include risk factors include age, genetics, smoking status, obesity and environmental factors.
How is Rheumatoid Arthritis treated?
There is no cure for rheumatoid arthritis, but symptoms and inflammation can be treated using NSAIDs, steroids, or synthetic or biologic DMARDs. The type of treatment will depend on the severity of symptoms and the number of years with rheumatoid arthritis.
How is Rheumatoid Arthritis diagnosed?
Current diagnoses include physical examination looking for signs of joint inflammation. Current biomarkers used in standard of care diagnosis include c-reactive protein (CRP) or erythrocyte sedimentation rate, which can indicate the presence of an inflammatory reaction. Other blood tests include rheumatoid factor and anti-cyclic citrullinated peptide which is present in some patients.
The medical need for biomarkers in rheumatoid arthritis today is two-fold. First, the diagnosis of rheumatoid arthritis remains a challenge because the signs and symptoms mimic those of many other diseases. Current biomarker techniques are imprecise and struggle to determine future prognosis of the patients.
Despite great progress in the availability of new and efficacious drugs in the last decades, a significant proportion of patients fail to respond to treatment or lose treatment effect over time. Exploratory biomarkers have the potential to greatly benefit patients, by aiding in the early diagnosis of disease and directing the most appropriate treatment at the right time. Furthermore, the use of Nordic biomarkers to enrich or stratify patients likely to respond to a therapeutic drug in development trials may reduce the trial length and size required to determine therapeutic efficacy.
Rheumatoid arthritis is characterized by inflammation and tissue destruction in the joints.
The tissues of the joint consist mainly of collagens. The collagens are remodeled as part of the normal homeostasis of the joint – that is, collagens are broken down and rebuilt as part of normal repair and maintenance of the tissue. In rheumatoid arthritis, the balance between degradation and formation of tissue is interrupted resulting in net degradation of the tissue. Nordic ProteinFingerPrint Technology™ biomarkers measured in our lab can quantify this tissue turnover directly in a serum sample.
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While the rheumatoid arthritis field has a number of diagnostic and disease activity biomarkers, their capacity for predicting treatment response is limited. There is therefore still a medical and drug development need for biomarkers that are able to characterize and quantify structural tissue change and predict disease progression and treatment response. In a clinical research setting, the tissue-derived Nordic ProteinFingerPrint Technology™ biomarkers can be measured in serum and used to accurately quantify changes in tissue turnover in the different joint tissues in the individual patient.
Biomarkers and tissue characterization:
Nordic ProteinFingerPrint Technology™ biomarkers measured in serum are generally increased in rheumatoid arthritis patients compared to healthy individuals and correlate to disease activity scores such as DAS, and radiographic scores such as JSN.
Nordic ProteinFingerPrint Technology™ biomarkers measured in serum are associated with established disease activity parameters, including DAS28, ESR and swollen joint count, generally increased in rheumatoid arthritis patients compared to healthy individuals and correlate to disease activity scores such as DAS, and radiographic scores such as JSN.
Nordic ProteinFingerPrint Technology™ biomarkers measured in serum at baseline are prognostic of radiographic progression including joint space narrowing (JSN), Sharp score (SHP) and Erosion score (ERN).
Nordic ProteinFingerPrint Technology™ biomarkers allow pharmacodynamic profiling of novel treatments by measuring protein degradation fragments directly in a serum sample.
Nordic ProteinFingerPrint Technology™ biomarkers are suppressed by effective treatments and the level of suppression is predictive of clinical response measured by ACR20, DAS remission or LDA.
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