Biomarkers to Predict DMARDs Efficacy and Adverse Effect in Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA), one of the most common immune system diseases, mainly affects middle-aged and elderly individuals and has a serious impact on the quality of life of patients. Pain and disability caused by RA are significant symptoms negatively affecting patients, and they are especially seen when inappropriate treatment is administered. Effective therapeutic strategies have evolved over the past few decades, with many new disease-modifying antirheumatic drugs (DMARDs) being used in the clinic. Owing to the breakthrough in the treatment of RA, the symptoms of patients who could not be treated effectively in the past few years have been relieved. However, some patients complain about symptoms that have not been reported, implying that there are still some limitations in the RA treatment and evaluation system. In recent years, biomarkers, an effective means of diagnosing and evaluating the condition of patients with RA, have gradually been used in clinical practice to evaluate the therapeutic effect of RA, which is constantly being improved for accurate application of treatment in patients with RA. In this article, we summarize a series of biomarkers that may be helpful in evaluating the therapeutic effect and improving the efficiency of clinical treatment for RA. These efforts may also encourage researchers to devote more time and resources to the study and application of biomarkers, resulting in a new evaluation system that will reduce the inappropriate use of DMARDs, as well as patients’ physical pain and financial burden.

Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases

“…Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown origin that is primarily characterized by chronic, progressive polyarthritis, but also frequently involves a broad spectrum of extra-articular organs by terms of inflammation [ 87 ]. In RA, patients lose self-tolerance, and start to produce autoantibodies.…”

“…There are numerous conventional and novel disease-modifying anti-rheumatic drugs available for the treatment of RA. Along with their immunosuppressive and immunomodulatory effects, however, several adverse effects must also be considered [ 87 ]. Thus, the secretome derived from MSCs with immunomodulatory properties could serve as a suitable therapeutic option.…”

Reestablish immune tolerance in rheumatoid arthritis

“…sDAMRDs can be divided into csDMARDs and tsDMARDs. All DMARDs are able to delay/modify disease progression and improve the prognosis of RA, just as the abbreviated name DMARDs implies (1,7). Commonly used representative csDMARDs include methotrexate, leflunomide and hydroxychloroquine.…”

“…With an increasing understanding of RA pathogenesis, the treatment methods for RA and their effects have been much diversified and improved. So far, DMARDs have developed from conventional synthetic DMARDs (csDMARDs) to biological DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) with rapid effect and high efficiency (1,7). Nevertheless, all existing DMARDs cannot overcome the adaptive immune disorders underlying RA.…”

Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis

“…Neovascularization is another hallmark of RA synovitis, in which multiple synovial infiltrates of the joint occur and endothelial cells are activated; furthermore, an expansion of synovial fibroblasts and macrophage-like cells leads to the proliferation of the supra-synovial layer and invasion of the periarticular bone at the cartilage junction, ultimately leading to bone erosion and cartilage degeneration ( 9 ). RA is incurable and patients must be treated with disease-modifying anti-rheumatic drugs (DMARDs) to relieve clinical symptoms, improve somatic function, and inhibit the progression of joint damage ( 10 ). Commonly used DMARDs include methotrexate, leflunomide, and sulfonamides.…”