Biomarker Combination Predicts Response to TNFi Treatment in Rheumatoid Arthritis

The combination of prealbumin, platelet factor 4, and S100A12 can accurately predict treatment response to TNFi for patients with RA.

A multivariate model combining 3 biomarkers — prealbumin, platelet factor 4, and S100A12 — can accurately predict treatment response to tumor necrosis factor α inhibitors (TNFis) for patients with rheumatoid arthritis (RA), according to results published in Joint Bone Spine.

Data also show that in patients with RA who are about to begin TNFi treatment, lower levels of prealbumin and S100A12 and a higher level of platelet factor 4 predict a positive treatment response.

The study included participants who were naive to biologic disease-modifying antirheumatic drugs and were starting TNFi treatment. Before treatment initiation, the researchers took baseline blood levels of C-reactive protein, platelet factor 4, apolipoprotein A1, prealbumin, α1-antitrypsin, haptoglobin, S100A8 protein, S100A9 protein, and S100A12 protein. Participants who had good European League Against Rheumatism response, based on the 28-joint disease activity score, at 6 months were considered to be responders.

Of the 53 participants included in the study, 43% were considered good responders, and 57% were considered nonresponders after 6 months of TNFi treatment. Using logistic regression, the researchers found that the combination of prealbumin, platelet factor 4, and S100A12 predicted a response to TNFi with a sensitivity of 78%, a specificity of 77%, a positive predictive value of 72%, a negative predictive value of 82%, a positive likelihood ratio of 3.35, and a negative likelihood ratio of 0.28.

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Disclosures: AB, CT, and PG generated intellectual property that is owned by Grenoble Alpes University and Centre Hospitalier Universitaire Grenoble Alpes. AB and PG are cofounders of Sinnovial. MVCN and AC are employees of Sinnovial.TL reports grants from Bristol-Myers Squibb and punctual interventions with personal fees from AbbVie, Bristol-Myers Squibb, Janssen, Eli Lilly & Co., Merck, Novartis, and Pfizer. OV has obtained grants from Bristol-Myers Squibb, MSD, and Pfizer, and reports grants punctual interventions with personal fees from Bristol-Myers Squibb, Pfizer, MSD, AbbVie, Roche-Chugai, Eli Lilly & Co., Novartis, Janssen, and UCB.


Nguyen MVC, Baillet A, Romand X, et al. Prealbumin, platelet factor 4 and S100A12 combination at baseline predicts good response to TNF alpha inhibitors in rheumatoid arthritis [published online June 6, 2018]. Joint Bone Spine. doi:10.1016/j.jbspin.2018.05.006