Innovative Diagnostic Test Improves Personalized Rheumatoid Arthritis Treatment

A groundbreaking clinical test developed by researchers at Queen Mary, University of London, promises to revolutionize the treatment approach for rheumatoid arthritis (RA) by accurately predicting which biological therapy will be most effective for individual patients on the first attempt. Currently, RA affects 1 in 100 people in Britain, and since it is caused by the immune system attacking the joints, timely and effective treatment is crucial. Biological therapies—engineered proteins from living cells—have significantly improved RA management, but due to genetic differences among patients, about 40% do not respond to initial treatments, necessitating multiple trial-and-error interventions. This not only prolongs patient suffering but also increases risks such as infections and severe side effects.

The novel method involves using deep molecular phenotyping and machine learning techniques on a small biopsy obtained from a patient’s affected joint. Unlike previous approaches relying on blood samples, which have proven ineffective with current technology, this technique analyzes the activity of 524 specific genes within the joint tissue to understand the internal cellular environment. The data collected are processed through three machine learning models, each tailored to predict response to one of the main RA therapies—etanercept, tocilizumab, and rituximab. These predictions enable clinicians to select the therapy most likely to succeed, reducing unnecessary treatments and associated risks.

The research, published in Nature Communications, demonstrates that these predictive models are accurate for 79%–85% of patients. Professor Myles Lewis highlights the potential benefits of this approach in improving patient outcomes and healthcare efficiency by ensuring the right medication is prescribed initially. Meanwhile, Professor Costantino Pitzalis emphasizes that this technological advance can minimize patient suffering and lead to more personalized, effective treatments. The team is now collaborating with commercial partners to adapt this approach for routine clinical use and is conducting large-scale trials involving gene sequencing of joint biopsies. This innovation represents a significant leap toward precision medicine in RA treatment, with the possibility of extending such techniques to other therapies in the future.

More details about this research can be found in the paper 'Deep molecular profiling of synovial biopsies in the STRAP trial identifies signatures predictive of treatment response to biologic therapies in rheumatoid arthritis.' (source: https://medicalxpress.com/news/2025-07-clinical-rheumatoid-arthritis-treatment.html)