Rheumatologists See Value in Test That Predicts Poor Response to Anti-TNFs

Almost 85% of American rheumatologists surveyed stated that health insurers should fully cover the costs of a test that can predict whether certain patients with rheumatoid arthritis will exhibit inadequate response to tumor necrosis factor inhibitor (TNFi) therapeutic agents.

In a study published in Rheumatology International, the authors reported their findings from a 32-question decision-impact survey completed by 248 rheumatologists about a commercial molecular signature test that identifies with 90% accuracy half of patients who will not achieve American College of Rheumatology 50 (ACR50) response criteria with TNFi in 6 months. Participants briefly learned about the predictive characteristics of the PrismRA test (called TEST-RA throughout the survey to reduce bias and conflicts of interest), and then responded to questions gauging its possible clinical utility.

Rheumatologists expressed a favorable view of the test, with 80.2% agreeing it would improve clinical decision making, 92.3% indicating it would increase their prescribing confidence, and 81.5% believing it would be helpful when considering TNFi therapies, according to the study.

As test signals of inadequate response increased in strength, rheumatologists said they would be less likely to prescribe TNFi therapies.

“The introduction of precision medicine would be welcomed by the rheumatology community, test results would lead to treatment changes, and patient care would improve,” researchers wrote, “by avoiding a medication class that would not result in meaningful change for those patients predicted to be inadequate responders.”

—Jolynn Tumolo

Reference

Pappas DA, Brittle C, Mossell JE 3rd, Withers JB, Lim-Harashima J, Kremer JM. Perceived clinical utility of a test for predicting inadequate response to TNF inhibitor therapies in rheumatoid arthritis: results from a decision impact study. Rheumatology International. 2021;41(3):585-593.