Identification of baseline gene expression signatures predicting therapeutic responses to three biologic agents in rheumatoid arthritis: a retrospective observational study

The aim of this study was to identify the specific molecular biological features predicting the therapeutic outcomes of three bDMARDs, infliximab (IFX), tocilizumab (TCZ), and abatacept (ABT) by studying blood gene expression signature of patients prior to biologic treatment in a unified test platform. GSEA analyses showed that inflammasome genes were significantly upregulated in IFX’s NON-REM compared with its REM. In TCZ’s REM, B cell-specifically expressed genes were upregulated. RNA elongation, apoptosis-related, and NK cell-specifically expressed genes were upregulated in ABT’s NON-REM. RA patients who responded inadequately to methotrexate and were later commenced with any one of IFX (n=140), TCZ (n=38), and ABT (n=31) as their first biologic between May 2007 and November 2011 were enrolled. Whole blood gene expression data were obtained prior to their biologic administration. They were defined as remission and non-remission groups, according to CDAI at 6 months of biologic therapy.