How rheumatoid arthritis patients can find the best treatment sooner
Posted: September 23, 2021 | Word Count: 926
If you or someone you love has been diagnosed with rheumatoid arthritis (RA), you probably know how debilitating it can be. What most people don’t know, is how hard it can be to find the right treatment.
That’s because RA is a complex disease that affects every person differently. RA affects 1.6 million Americans and can begin at any age, causing swelling and joint pain — usually in small joints of the hands, wrists, knees, and feet. The pain can make even simple, daily activities like combing your hair or standing up difficult and painful. According to the American College of Rheumatology (ACR), if untreated, the disease becomes progressively worse.
However, while there are many FDA-approved drugs for the disease, in the past doctors had no way of knowing if one was more likely to work for you over another. Finding the drug you respond to can take years.
Ashley, only 42 years old, was diagnosed with RA nearly five years ago, and is still working with her doctor to find the treatment that works best for her.
“Coming up on five years, I really still haven’t found a medication that fully meets my needs,” Ashley, a working mother, explained. “I think I’m on medication number 4, possibly actually number 5. For each of those I did have to stay on the medications for a period of several months before we were able to declare that they were working or not and that was really difficult.”
The journey toward the right treatment
Autoimmune diseases like RA are complicated, affecting different people in different ways. Doctors seeking the best treatment for RA patients strive to achieve results including:
- reduced pain
- reduced damaging joint inflammation
- increased joint flexibility
Some medications work well for some patients but not others regardless of dose or may have positive results in only one or two of these areas.
To find the most effective treatment, your healthcare provider often takes a “wait-and-see” approach, trying one therapy at a time to monitor your response to each one. Unfortunately, because it can take 4-6 months to determine if one medication is having the desired response, this can mean a delay of a year or longer before finding an effective treatment.
Meanwhile, the damage to the patients’ joints and their daily discomfort continues.
If a patient has not responded well to medications such as methotrexate and leflunomide, 90% of people living with RA are prescribed what’s called a TNF inhibitor (TNFi) therapy as the next line of treatment. However, a majority of patients fail to respond adequately to TNFi medications.
Studies show that patients who do not find an effective treatment early may be more likely to:
- experience increased cardiovascular disease
- 83% more surgeries, and twice as many emergency visits and hospitalizations
- experience more severe symptoms
- use multiple medications at once, including opioids, to control the disease
How healthcare providers can find the best therapy faster
Rheumatologists and patients seeking a way to determine the best treatment for each patient now have a new tool, in a routine blood test. PrismRA® from Scipher Medicine is a first-of-its-kind test that gives physicians and healthcare providers specific information about each patients’ unique biology, to help them reach their RA treatment decisions sooner. The test analyzes a patient’s unique molecular signature, predicting if the patient is well-suited or not for TNFi therapies such as adalimumab, certolizumab pegol, etanercept, golimumab and infliximab — with 90% accuracy.
Providers can help improve patient outcomes by identifying those unlikely to respond adequately to TNFi therapies prior to beginning treatment and directing them to a more appropriate therapy faster.
HealthiVibe, a division of CorEvitas, LLC, a research and consulting company, surveyed 248 rheumatologists about the clinical usefulness of the PrismRA test in their daily practice. Over 80% of the survey respondents agreed that PrismRA would improve their clinical decision-making, while 9 out of 10 said that it would improve their confidence in prescribing decisions.
“Clearly there has been an unmet need for a test like this for twenty-five years or more,” said rheumatologist James Mossell, Doctor of Osteopathic Medicine and Fellow of the American College of Rheumatology, a co-author on the study. “We have been waiting for the ability to order a test to stratify which patients would respond to which medications for a long time. Our goal is to get the best possible treatment to the patient from day one, and PrismRA will help us do that.”
If you and your doctor want help finding the right RA treatment for you, ask your healthcare provider for a PrismRA test, or visit www.PrismRA.com/Contact for a downloadable form you can take to your doctor.
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 Cohen S, et al. A molecular signature response classifier to predict inadequate response to tumor necrosis factor-? inhibitors: the NETWORK-004 prospective observational study. Rheumatology and Therapy volume 8, pages 1159–1176 (2021). (https://link.springer.com/article/10.1007%2Fs40744-021-00330-y)
 Pappas DA, et al. Perceived clinical utility of a test for predicting inadequate response to TNF inhibitor therapies in rheumatoid arthritis: results from a decision impact study. Rheumatology International volume 41, pages 585–593 (2021). (https://link.springer.com/article/10.1007%2Fs00296-020-04746-7)