What’s Ahead for Rheumatology in 2019?

“A vast array of novel targets and immunotherapies have been tested for SLE treatment, but most have failed in clinical trials,” said Meenakshi Jolly, MD, MS, director of the Rush Lupus Clinic at Rush University Medical Center in Chicago, IL. “And as a result, lupus researchers are now beginning to look at lupus treatment from a different viewpoint. Perhaps there are certain subsets of patients with SLE that may respond favorably to one medication over another. Understanding the mechanisms and predictors for response or lack of response to medications may pave the way for personalized medicine in SLE. New clinical trial designs are being tested, and better outcome measures to define success are being explored. Also, an international collaboration of lupus researchers is engaged in developing and testing new classification criteria for SLE.”

Arthur M. Mandelin II, MD, PhD, RMSK, RhMSUS, associate professor of medicine, Northwestern University Feinberg School of Medicine in Chicago, IL, conducts translational research as a member of the Northwestern University Clinical and Translational Sciences Institute (NUCATS). He reported that “one of the biggest recent developments in translational research has been the move toward precision medicine, in which we are investigating ways in which the patient might someday be tested at the time of diagnosis in order to gain insights into disease characteristics, prognosis, and even treatment.

There is growing interest in defining biomarkers that help to better subcategorize different forms of inflammatory arthritis, according to Dr. Bingham. “Work in a number of labs is now focusing on the use of individual cell-based assays from peripheral blood and synovium to better characterize the activation status of cells in the blood and microenvironment. Coupled with advances in data science that allow analysis of increasingly complex datasets, I would anticipate that these new technologies will begin to provide meaningful readouts in the near future that will help to better define pathogenic subsets of patients that may then help to better target therapies.”