Spondyloarthritis & psoriatic arthritis
Identification of patient endotypes and adalimumab treatment responders in axial spondyloarthritis using blood-derived extracellular matrix biomarkers
Authors' conclusion
These endotypes differ in their tissue remodelling profile and may in the future have utility for patient stratification and treatment tailoring.
Study context
- Population
- Patients with axSpA in three studies: MASH (cross-sectional, n=41), ASIM and DANISH RCTs of adalimumab vs placebo every other week for 6 or 12 weeks, then active treatment3 studies · ASIM 45 · DANISH 49
- Comparison
- ECM biomarker-derived endotypes compared on disease activity and response to adalimumab
Methodological detailsone cross-sectional study and two randomised trials, principal component analysis, K-means clustering, double-blind, placebo-controlled
- One cross-sectional study and two randomised trials
- Principal component analysis
- K-means clustering
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Endotypes from 14 blood-based ECM biomarkers
- Two orthogonal dimensions: (1) inflammation and neutrophil activity (driven by collagen by metalloproteinases (C1M) and CPa9-HNE) and (2) collagen turnover (driven by PRO-C2)
- Three endotypes identified: high inflammation (Endotype1), low inflammation (Endotype 2) and high collagen turnover (Endotype3)
- Endotype1 had higher baseline disease activity (Ankylosing Spondylitis Disease Activity Score (ASDAS)) than Endotype2 and Endotype3
- Endotype1 had a higher percentage of adalimumab responders by ASDAS clinical improvement at week 24
- Endotype3 had a higher percentage of patients with BASDAI 50% improvement at week 24 than Endotype2
Original publication
Identification of patient endotypes and adalimumab treatment responders in axial spondyloarthritis using blood-derived extracellular matrix biomarkers. RMD Open. Published 10 January 2024. doi:10.
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