Predictors of exposure, therapeutic and adverse effects of certolizumab pegol, baricitinib and tocilizumab used in the treatment of rheumatoid arthritis.

Rheumatoid arthritis (RA) is the most common auto-immune inflammatory disease in adults. The World Health Organization estimates more than 23 million people live with rheumatoid arthritis; this constitutes approximately 1% of the world population. There have been a number of important developments in the treatment of rheumatoid arthritis in the last decade including the introduction of certolizumab pegol, tocilizumab and baricitinib. However, response and toxicity to certolizumab pegol, baricitinib and tocilizumab can be unpredictable. For example, approximately 40% of the eligible patients who initiate certolizumab pegol, baricitinib or tocilizumab therapy for rheumatoid arthritis do not respond, while 40% may also experience some toxicity. Thus, more research is required to confirm and explore novel predictive markers of therapeutic and adverse effects of certolizumab pegol, baricitinib and tocilizumab in the treatment of rheumatoid arthritis.
Using the diverse range of data collected from clinical trials, it is possible to develop clinical tools that enable improved prediction of therapeutic and adverse outcomes of patients using certolizumab pegol, baricitinib or tocilizumab in the treatment of rheumatoid arthritis. Being able to identify the expected response and adverse effect profile may enable patients and clinicians to make better decisions regarding whether to commence, continue, discontinue or change dosing of certolizumab pegol, baricitinib and tocilizumab .
Available data from rheumatoid arthritis patients treated with certolizumab pegol, baricitinib and tocilizumab and relevant comparator arms (e.g. methotrexate or adalimumab) will be analysed to identify and validate predictors of the most important adverse effects, and clinical/biological/patient predictors of therapeutic outcomes such as response / progression, quality of life and survival.