Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Varvara Choida; Margaret Hall-Craggs; Bethany R Jebson; Corinne Fisher; Maria Leandro; Lucy R Wedderburn; Coziana Ciurtin

doi:10.3389/fphar.2020.635823

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Front Pharmacol. 2021 Feb 2:11:635823. doi: 10.3389/fphar.2020.635823. eCollection 2020.

Authors

Varvara Choida^{1

2}, Margaret Hall-Craggs³, Bethany R Jebson^{1

4}, Corinne Fisher^{1

2}, Maria Leandro^{1

2}, Lucy R Wedderburn^{1

4

5}, Coziana Ciurtin^{1

2}

Affiliations

¹ Centre for Adolescent Rheumatology Versus Arthritis at UCL UCLH and GOSH, Division of Medicine, University College London, London, United Kingdom.
² Department of Adolescent Rheumatology, University College London Hospital, London, United Kingdom.
³ Centre for Medical Imaging, University College London, London, United Kingdom.
⁴ University College London Great Ormond Street Institute for Child Health, London, United Kingdom.
⁵ NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, United Kingdom.

Abstract

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritis of childhood, characterized by various clinical phenotypes associated with variable prognosis. Significant progress has been achieved with the use of biologic treatments, which specifically block pro-inflammatory molecules involved in the disease pathogenesis. The most commonly used biologics in JIA are monoclonal antibodies and recombinant proteins targeting interleukins 1 (IL-1) and 6 (IL-6), and tumor necrosis factor α (TNF-α). Several biomarkers have been investigated in JIA. Aims: To assess the level of evidence available regarding the role of biomarkers in JIA related to guiding clinical and therapeutic decisions, providing disease prognostic information, facilitating disease activity monitoring and assessing biologic treatment response in JIA, as well as propose new strategies for biologic therapy-related biomarker use in JIA. Methods: We searched PubMed for relevant literature using predefined key words corresponding to several categories of biomarkers to assess their role in predicting and assessing biologic treatment response and clinical remission in JIA. Results: We reviewed serological, cellular, genetic, transcriptomic and imaging biomarkers, to identify candidates that are both well-established and widely used, as well as newly investigated in JIA on biologic therapy. We evaluated their role in management of JIA as well as identified the unmet needs for new biomarker discovery and better clinical applications. Conclusion: Although there are no ideal biomarkers in JIA, we identified serological biomarkers with potential clinical utility. We propose strategies of combining biomarkers of response to biologics in JIA, as well as routine implementation of clinically acceptable imaging biomarkers for improved disease assessment performance.

Keywords: biologics; cellular biomarkers; imaging biomarkers; juvenile idiopathic arthritis; serological biomarkers.

Publication types

Review

Abstract

Publication types

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