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PrismRA and Vectra: Diagnostic Blood Tests

Rheumatoid Arthritis (RA) is a progressive autoimmune disease that, if untreated, can attack the joints and internal organs. Said another way, TTD (Time to Diagnosis) very much matters – that’s why we aim to get new patients into Remission Medical (National Virtual Clinic for Rheumatology) in same-day.  

There are medications that can help block inflammation, but discerning the right therapy is often trial and error, hit and miss. Yet there are diagnostic tests that can enhance the decision making of prescribing medication.

Several first-line medications, called TNF inhibitor therapies, are designed to block the inflammation associated with RA, and the drugs often take months to work. One-time blood tests can give clinicians a better window into the condition. One is called PrismRA, a test that uses proteins in a person’s blood to help determine the cause of rheumatoid arthritis and whether TNF inhibitors are likely to work.

If the blood test says that a given patient is not likely to respond to a TNF inhibitor, providers such as those at Remission Medical can save many weeks of treatment that doesn’t work.

The PrismRA test involves a one-time blood draw and is covered by some insurance companies.  The PrismRA test analyzes each patient’s molecular signature to determine whether they’ll respond to tumor necrosis factor inhibitor, or TNFi, therapy. The drug class is prescribed to an estimated 90% of the 20 million RA patients around the world but is only clinically effective in about one-third of those prescribed, according to Scipher, the maker of PrismRA..

The two-thirds of patients who are on futile TNFi regimens, meanwhile, may experience accelerated disease progression and bone erosion as well as an increased reliance on opioids to manage their continuing symptoms.

One study of the PrismRA test, published in Expert Review of Molecular Diagnostics, showed that it can vastly improve targeted RA treatment outcomes, resulting in a clinical response three times better than that of patients whose treatments weren’t guided by the blood test.

In the study, researchers assessed the treatment choices and subsequent clinical outcomes for 212 patients whose healthcare providers had performed the PrismRA test.

The test results were used to guide treatment decisions in 74% of the patients, and that group responded to those personalized therapies with triple the success rate of the remaining patients.

 

In the group whose RA treatments weren’t guided by PrismRA results, some were given TNFi therapies even though their tests indicated that they were non-responders. Indeed, according to the study, 90% of that particular subset failed to respond to a TNFi regimen, proving that time may be wasted and health outcomes potentially worsened when PrismRA’s findings aren’t followed. 

 

Along with improving outcomes and speeding up the amount of time it takes to get patients started on a successful treatment regimen, utilizing blood tests like those from Scipher, Myriad Genetics (the Vectra RA test, now owned by Labcorp), Oxford BioDynamics (EpiSwitch) and more to predict drug response could also save quite a bit of money by helping patients and their healthcare and insurance providers avoid purchasing potentially unsuccessful and extremely costly RA drugs.