Clinical Review State of the Art Review

Biomarkers in rheumatic diseases: how can they facilitate diagnosis and assessment of disease activity?

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5079 (Published 26 November 2015) Cite this as: BMJ 2015;351:h5079
  1. Chandra Mohan, professor1,
  2. Shervin Assassi, associate professor2
  1. 1Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA
  2. 2Division of Rheumatology, University of Texas Health Science Center at Houston, Houston
  1. Correspondence to: S Assassi shervin.assassi{at}uth.tmc.edu

Abstract

Serological and proteomic biomarkers can help clinicians diagnose rheumatic diseases earlier and assess disease activity more accurately. These markers have been incorporated into the recently revised classification criteria of several diseases to enable early diagnosis and timely initiation of treatment. Furthermore, they also facilitate more accurate subclassification and more focused monitoring for the detection of certain disease manifestations, such as lung and renal involvement. These biomarkers can also make the assessment of disease activity and treatment response more reliable. Simultaneously, several new serological and proteomic biomarkers have become available in the routine clinical setting—for example, a protein biomarker panel for rheumatoid arthritis and a myositis antibody panel for dermatomyositis and polymyositis. This review will focus on commercially available antibody and proteomic biomarkers in rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), dermatomyositis and polymyositis, and axial spondyloarthritis (including ankylosing spondylitis). It will discuss how these markers can facilitate early diagnosis as well as more accurate subclassification and assessment of disease activity in the clinical setting. The ultimate goal of current and future biomarkers in rheumatic diseases is to enable early detection of these diseases and their clinical manifestations, and to provide effective monitoring and treatment regimens that are tailored to each patient’s needs and prognosis.

Footnotes

  • Contributors: CM and SA both contributed to conception of the work, literature search, data interpretation, manuscript preparation, and approval of the final version of the manuscript. SA is guarantor.

  • Funding: This review is supported by funds from the National Institutes of Health K23-AR-061436 (SA) and the Scleroderma Foundation Collaborative Research Grant.

  • Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: none.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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