Genetic and clinical markers for predicting treatment responsiveness in rheumatoid arthritis

Although many drugs and therapeutic strategies have been developed for rheumatoid arthritis (RA) treatment, numerous patients with RA fail to respond to currently available agents. In this review, we provide an overview of the complexity of this autoimmune disease by showing the rapidly increasing number of genes associated with RA. We then systematically review various factors that have a predictive value (predictors) for the response to different drugs in RA treatment, especially recent advances. These predictors include but are certainly not limited to genetic variations, clinical factors, and demographic factors. However, no clinical application is currently available. This review also describes the challenges in treating patients with RA and the need for personalized medicine. At the end of this review, we discuss possible strategies to enhance the prediction of drug responsiveness in patients with RA.

The long-term prognosis and predictors of epilepsy:a retrospective study in 820 patients

Background:To investigate the prognosis and predictors for seizure control in epileptic patients in China.Methods:Eight hundred and twenty patients with epilepsy who visited Xuanwu Hospital from October 2017 to January 2020,were enrolled.The clinical information of the patients was obtained by retrospectively reviewing medical records.Prognostic measures of seizure control included remission,relapse and occurrence of drug resistance.The relationship of prognosis of seizure control with factors such as demographics,clinical characteristics and initial electroencephalography(EEG)features was investigated.Results:A total of 503(61.3%)patients experienced a 1-year remission and 330(49.3%of 669)had a 2-year remission.Idiopathic type of epilepsy(P<0.001),normal EEG(P<0.05),number of antiepileptic drugs(P<0.05)and seizure frequency of<1/month(P<0.001)at the first arrival predicted a remission independently.Of the 503 patients who achieved a 1-year remission,184(36.6%)experienced a relapse,due to external reversible causes(58 patients)or with unknown reversible triggers(126 patients).No factors were found to be associated with a relapse(P>0.05).At the end of the study,322 patients(39.3%)developed drug resistance.The development of drug resistance was associated with the following factors:symptomatic aetiology of epilepsy,epileptiform abnormality in EEG,number of antiepileptic drugs and seizure frequency of≥1/month at first arrival(P<0.001).For symptomatic epilepsy,patients with meningitis/encephalitis(P=0.007)were more likely to develop drug-resistant epilepsy than these with other causes.Conclusions:Remission is a common process.The type of epilepsy(idiopathic or symptomatic),EEG features,seizure frequency and treatment history at first arrival are related to both remission and terminal drug resistance.Among various causes of symptomatic epilepsy,meningitis/encephalitis is associated with the worst prognosis of epilepsy.