Destination: Personalized Disease Management Approaches for People with Autoimmune Diseases

A biomarker is a characteristic that can be objectively measured as an indicator of normal or pathologic biological processes, or as an indicator of response to therapy. As such, biomarkers have generated significant interest within the autoimmune disease research and medical communities because of their potential to help physicians make predictions about disease progression and to serve as guides for therapeutic decision making. In the future, biomarkers, coupled with other personal genetic information, may be used to inform personalized treatment strategies, i.e., “road maps” – disease management plans for individual patients that can be followed and revised over time. Bristol-Myers Squibb’s research focus is on unlocking the full potential of precision medicine approaches to patient care, in order to get to a destination where we can improve and/or optimize outcomes for people living with autoimmune diseases.

Our journey in this area began 20 years ago when we pioneered the science of modulating the body’s immune response to treat disease with our rheumatoid arthritis research. Rheumatoid arthritis is an autoimmune disease that causes joint damage with chronic pain, stiffness, and swelling of joints. Our research was grounded in the understanding that rheumatoid arthritis could present and behave very differently in different individuals. We, therefore, worked to identify a different approach to treatment.

Along the way, we’ve uncovered insights about people who have a more highly active and progressive form of the disease, which can lead to worse outcomes. These patients frequently test positive for a biomarker called anti-citrullinated protein antibody, or ACPA. ACPA, which is found in 70-90% of rheumatoid arthritis patients, can be detected in a person’s bloodstream before the joint damage becomes clinically apparent, offering physicians important, predictive information.

We are sharing clinical and real-world data suggestive of the impact of ACPA positivity in rheumatoid arthritis, from both the patient outcomes and health economic perspectives, at the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting. We’re proud to be a part of advancing the scientific understanding of the pathophysiology of rheumatoid arthritis and of the value of this biomarker in the prognosis and treatment of this disease, and our work isn’t stopping there. Our aspiration is to deliver life-changing medicines tailored for individual patients with a range of other autoimmune diseases where unmet needs persist and patients continue to seek improvements, despite available therapies.

Our scientists are inspired by this vision every day as they conduct their immunoscience research. At the 2018 ACR/ARHP Annual Meeting, we are presenting findings from biomarker research in patients with rheumatoid arthritis who develop another autoantibody-mediated condition called Sjögren’s syndrome. Sjögren’s syndrome can affect multiple parts of the body, but most often affects the tear and saliva glands. Bristol-Myers Squibb is leveraging its rheumatoid arthritis research expertise to better understand other autoimmune diseases where a precision medicine approach may prove relevant.

These include:

  • Systemic lupus erythematosus, referred to as SLE or lupus, causes systemic inflammation affecting multiple organs, including skin, joints, kidneys, heart, and brain. Our research is exploring targets based on the pathophysiology of the disease.
  • A type of kidney disease caused by lupus is called lupus nephritis. Over time, this kidney disease may get worse and lead to kidney failure. Though a study of one potential treatment approach did not meet its primary endpoint, we are digging deeper into the data because they may shed light on potential future research directions and biomarker involvement in this disease.

Our hope is that as our research continues, and large-scale DNA sequencing continues to open up even more opportunities for the discovery of novel biomarkers in autoimmune disease, we’ll get closer to our goal of advancing personalized approaches to treatment strategies such that the “right treatment is provided to the right patient.” Treatment discovery and improvement can be a long road with many twists and turns. Our scientists are committed to leveraging our expertise in drug discovery and translational medicine, as well as the latest biomarker science, to help get to a place where we can improve the lives of those touched by autoimmune diseases.

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