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Using biomarkers to predict long-term outcomes in juvenile idiopathic arthritis
A study to be presented today at the European League Against Rheumatism Annual Congress (EULAR 2014; Abstract Number: OP0187) sheds light on how biomarkers identified from whole blood gene expression profiles in children with juvenile idiopathic arthritis (JIA) could be harnessed to predict disease status at 12 months. The study highlights the fact that long-term disease status could only be accurately predicted after treatment initiation in newly diagnosed patients.

Juvenile idiopathic arthritis is the most common of the childhood (i.e. under 16 years of age) rheumatic diseases, affecting between 16-150 out of every 100,000 children. The causes of this devastating condition are not well understood. The symptoms include pain and swelling in joints, tenderness and stiffness lasting for more than six weeks and can also affect the eyes and lymph nodes. While gene expression profiling has brought the rheumatology field forward, it has so far only been possible to use biomarkers to predict therapeutic outcome at 6 months. Longer term predictions have proved elusive. Lead author on the current study, Professor James Jarvis of the University of Buffalo explains the importance of advancing biomarker profiling to allow longer-term predictions: "By predicting disease progression in these young children we can better understand the course of the disease and how best to treat the individual."

In the study, researchers constructed whole blood gene expression profile from children enrolled in the NIH-funded TREAT study, which is a clinical trial comparing methotrexate (MTX) with MTX + etanercept in children with newly-diagnosed JIA. The profiles were used to identify genes whose expression best predicted the twelve month outcome in terms of presence of active versus inactive disease. The research team found that while baseline expression profiles could be used to predict disease status at six months, they could not accurately predict the twelve month status. However, samples collected at 4 months after diagnosis from children on treatment were strongly predictive of the 12 months status. The study uncovered differences in response mechanisms between children who were positive for Rheumatoid Factor versus those who were negative, shedding light on the relative refractoriness of Rheumatoid Factor positive patients to therapies that are effective in other patients.


Yao J, Jiang K, Franks MB et al. Developing prognostic biomarkers from whole blood expression profiling in Juvenile Idiopathic Arthritis: Influence of early therapy on treatment outcome. EULAR 2014; Paris: OP0187

Press release: European League against Rheumatism; available from [Accessed 13 June 2014]
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Using biomarkers to predict long-term outcomes in juvenile idiopathic arthritis00