In a recent meta-analysis, published in RMD Open, researchers sought to identify laboratory biomarkers that predicted response to tumor necrosis factor inhibitor (TNFi) therapy in patients with rheumatoid arthritis.

The study’s lead author, Maike Wientjes, reported that the team was unable to identify any biomarkers with a consistently strong predictive value for response to TNFi therapy.

The systematic literature review included 41 studies from the Cembase, PubMed, and Central databases that included predictive accuracy of laboratory biomarkers, or included data that allowed accuracy to be calculated.

Predictors of TNFi Response in RA Remain Elusive

Researchers presented likelihood ratios for laboratory biomarkers, with ratios between 2-10 and 0.5-0.1 considered weak predictors and ratios >10 or <0.1 considered strong predictors of response.

Investigators primarily focused on 5 laboratory biomarkers that were studied 3 or more times across the enrolled reports:

• anti-cyclic citrullinated peptide (CCP)
• rheumatoid factor
• TNF-α -308 polymorphism
• SE copies in HLA-DRB1 gene
• FcGR2A polymorphism

Overall, the authors found no studies identified any laboratory biomarkers with a strong predictive association with TNFi therapy response in patients with rheumatoid arthritis. They noted one included study reported a weak positive association between TNFi response and anti-CCP parameters.

“Given the disappointing yield of previous predictive biomarker research,” the authors closed, “future studies should focus on exploring, combining and validating the most promising laboratory biomarkers identified in this review, and searching for new predictors.”

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