“RA is heterogeneous, but people sometimes think about it in superficial ways without looking through the lens of molecular medicine. This is very relevant for discovery and development of new treatments for different subsets of RA,” Dr. Tak says. The kind of subtyping illustrated in the Orange study, he notes, eventually could point toward stratified and precision medicine approaches in the treatment of RA.
Larry Beresford is a medical journalist in Oakland, Calif.
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References
- Orange DE, Agius P, DeCarlo EF, et al. Identification of three rheumatoid arthritis disease subtypes by machine learning integration of synovial histologic features and RNA sequencing data. Arthritis Rheumatol. 2018 May;70(5):690–701.
- van Baarsen LG, Wijbrandts CA, Timmer TC, et al. Synovial tissue heterogeneity in rheumatoid arthritis in relation to disease activity and biomarkers in peripheral blood. Arthritis Rheum. 2010 Jun;62(6):1602–1607.
A Synovitis Pathology Website
The Hospital for Special Surgery has developed a synovitis pathology website with a scoring image directory for synovial pathology, instructions for how to score histology features and the machine-learning algorithm described in this article.
