A novel treatment algorithm for PsA is being developed to provide more precise biologic choices. psoriaticarthritis GRAPPA2022
NEW YORK — An algorithm in development for psoriatic arthritis is showing promise for directing patients to the biologic with the greatest likelihood of producing disease control, according to a proof-of-concept study presented at the annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis.
The principle of the new algorithm that she and her coinvestigators are pursing is based on immunophenotype analysis conducted with a flow-cytometric cytokine secretion assay . In the protocol, monocytes obtained from peripheral blood undergo activation before an FCCSA to distinguish patients by their T-cell behavior.
"From the time a blood sample is obtained, the method provided results within 24 hours," according to Ayan, who is now planning a randomized trial to test the ability of the algorithm to improve clinical outcomes. If"yes," they are evaluated for percentage of IL-22 to IL-17 CD4+. If the IL-22 CD4+ percentage is lower than the IL-17 CD4+ percentage, meaning a"yes" to this decision point, they are directed to an IL-17 inhibitor. If the answer at this decision point is"no," they are directed to an IL-12/23 inhibitor.
Based on the feasibility of this method for subtyping patients by T-cell behavior to guide drug selection, Ayan anticipates pursuing the additional steps that would show the algorithm makes a difference to patient care, including such adjunctive benefits as more cost-effective treatment selection.
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