There is an expanding array of biologic therapies that can be used to treat autoimmune diseases, including B cell depletion, T cell costimulation blockade, and neutralization of specific cytokines (TNF, IL-1, and others). However, there are no tools to help predict which therapy will work best in an individual patient. We are using high-dimensional analyses of patient blood and tissue samples to identify active immune pathways in individual patients that guide selection of effective therapies.
The TARGET Trial is an NIH/NIAMS funded trial that aims to determine which treatments for rheumatoid arthritis reduced cardiovascular risk. Patients with rheumatoid arthritis suffer a 50% increase in cardiovascular risk but there is little known about which treatments are best to reduce this risk. This trial uses FDG PET/CT scanning to assess cardiovascular risk and is collecting a large group of biomarkers to help subset patients into various risk groups. As well, two different randomized treatment arms will facilitate detailed analyses of which patients respond best to different treatments for rheumatoid arthritis.
Rheumatoid arthritis (RA) is a systemic autoimmune disease that causes inflammatory arthritis. Patients with RA have excess cardiovascular and respiratory morbidities and have excess mortality compared to the general population. Our group is using precision medicine to understand the etiology, optimize treatment, and decrease the morbidity burden for patients with RA using clinical trials, observational cohort research studies, and harnessing the wealth of data in electronic medical records.