Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is a common, archetypal autoimmune disease that results in a chronic, systemic inflammatory disorder and occurs in about 1% of the adult population.
- RA principally affects synovial tissues but also other tissues and visceral organs (heart, pericardium, lungs)
- In its early phase, RA affects joints of the hand and foot and in later stages, other joints and occasionally the spine
- Long-term consequences associated with RA are erosive joint destruction, deformation and functional impairment
Current diagnostic tools for RA
The clinical diagnosis of RA is based on symptoms, physical exams, radiographs and the presence of autoantibodies and inflammatory markers. There is no cure available and current recommendations are to start disease modifying anti-rheumatic treatment at the earliest opportunity.
Current diagnostics include tests to detect serum levels of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs), specifically anti-CCP (cyclic citrullinated peptide) and anti-MCV (antibodies against mutated citrullinated Vimentin), However, these tests show positivity in only a proportion of the RA population (15% for RF, 60-70% for anti-CCP), leaving a number of patients where the condition cannot be detected.
Unmet clinical diagnostic needs
Efforts to improve RA patient treatment should be focused on the early identification, diagnosis and initiation of disease-modifying antirheumatic drug (DMARD) treatment. One key aim is to be able to identify asymptomatic individuals that have a high risk of developing RA so that clinicians can intervene as early as possible. This presents a current unmet diagnostic need in the clinic.
Using current methods, it is difficult to characterize the specific time frame that defines early RA. RA diagnosis has a sensitivity of 58-91% in patients with less than 2 years of symptom duration and 62-74% with symptoms present for less than 3 months.
Despite some success in improving treatment, progress is still hampered due to limited knowledge about specific diagnostic and prognostic biomarkers, the likes of which could more accurately guide early therapy. This is especially relevant given that the over-diagnosis of RA is now also a concern. [link here instead of providing stats]
Novel biomarkers for RA diagnostics
Novel diagnostic biomarkers are required for the early prediction of disease onset, classification of subjects into disease subgroups and the assessment of response to therapy. Tests capable of this would allow us to:
- identify specific, personalized therapeutic strategies
- improve patient prognosis and disease management
- reduce the ineffective, and often costly, administration of treatment
- limit unnecessary side effects
- differentiate RA patients from other rheumatic conditions such as lupus or ankylosing spondylitis, planning subsequent treatment accordingly
In collaboration with key specialists in rheumatology, we have identified novel autoantibody candidates as promising biomarkers for RA by comparative screening. These new biomarkers have been applied to specific RA test panels that provide improved differential diagnosis, patient stratification and response prediction, allowing us to identify to best course of treatment for individual patients.
Putting novel diagnostic tools in your hands
Using our proprietary biomarker libraries, we have identified specific autoantibody signatures for accurate RA diagnosis and are applying this to our diagnostic test pipeline.
We are also working alongside industry partners and pharmaceutical customers using our diagnostic platform and extensive internal rheumatology expertise to guide drug and companion diagnostic test development for the approval of new, more effective therapeutics.