Personalized Medicine Advancing Rheumatology

Alice Goodman

October 18, 2013

SAN DIEGO — Rheumatology has lagged behind oncology when it comes to the clinical application of personalized medicine, including biomarkers, genomics, and mutational analysis, but that is about to change, say organizers of the American College of Rheumatology (ACR) 2013 Annual Meeting, which will be held October 26 to 30.

Program chair Chester Oddis, MD, noted that several keynote lectures, oral sessions, and posters will focus on bringing the molecular understanding of rheumatic diseases forward from the bench to the bedside.

Two key studies to be presented at a plenary session will explore triple therapy and whether this might be the best way to initiate treatment for early rheumatoid arthritis (RA). "The idea here is to hit early RA harder right off the bat," said Dr. Oddis.

Basic science chair John Varga, MD, cited several keynote lectures related to the theme of integrating basic science and clinical science. "Traditionally, our studies focused on mice or people. We realize now that the translational-clinical interface is key, and several of our talks reflect that," he said.

Atul Butte, MD, will lecture on data-mining huge amounts of genomic, genetic, and phenotypic information to determine which currently available drugs might work in which patient.

I'm really looking forward to this talk, because in the current healthcare environment, any money we can save in caring for our patients is great.

Three different speakers will discuss the omics of osteoarthritis — proteomics and genomics — and what we might have missed so far using systems biology to make treatment discoveries.

Another 3-speaker session on so-called inflammasomes in health and disease will explore how this inflammatory component of rheumatic diseases can be targeted with newer drugs.

"The theme is that we can find new approaches to intractable rheumatic diseases like OA with data-mining and omics," Dr. Varga said. "This relates to personalized medicine. One of the main problems in the field is that we treat every patient with lupus or every patient with scleroderma the same, yet each patient is different. The data-mining approach can help us select the right drug for the right patient."

Clinical program chair Mary Cronin, MD, singled out a late-breaking presentation on biosimilars by Dae-Hyun Yoo as important for the field of rheumatology. This presentation will focus on the effectiveness, potency, and adverse effects of biosimilars, compared with their patented biologic counterparts.

"Hearing about results of trials of biosimilars may change the care of our patients. I'm really looking forward to this talk, because in the current healthcare environment, any money we can save in caring for our patients is great," Dr. Cronin said.

She noted that she is also looking forward to the great debate on triple-drug therapy vs biologics in patients with RA, with Ronald van Vollenhoven, MD, on the pro biologic side, and James O'Dell, MD, on the side of triple therapy.

The Great Debate

"Don't just go to the debate," Dr. Cronin said. "Go hear the studies about triple therapy vs biologics and triple therapy vs monotherapy."

J. Craig Venter, PhD, will give the opening lecture. "Here is a pathfinder in synthetic genomics who took basic science from the lab and made it into a profitable business," Dr. Cronin said. "His discoveries will have a profound effect on the future of medical care for all patients, and our children and grandchildren."

For a really good time, Dr. Cronin recommends the ACR Knowledge Bowl on Sunday and Monday, with 12 teams of fellows and program directors from different institutions pitted against one another in a contest modeled on the television show Jeopardy. "This is a lot of fun and very well done."

Dr. Cronin said, "I come to ACR to hear the newest basic and clinical science to improve care of my patients. I also come to meet old friends and make new ones."

Dr. Oddis reports financial relationships with Questcor and Tyr Pharma. Dr. Varga reports no relevant financial relationships. Dr. Cronin reports relationships with Lilly, GSK, and the Astellas Research Institute of America.


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