Guidelines for biomarkers in autoimmune rheumatic diseases - evidence based analysis

Publication date: Available online 5 November 2018

Source: Autoimmunity Reviews

Author(s): Roberto Giacomelli, Antonella Afeltra, Alessia Alunno, Elena Bartoloni-Bocci, Onorina Berardicurti, Michele Bombardieri, Alessandra Bortoluzzi, Roberto Caporali, Francesco Caso, Ricard Cervera, Maria Sole Chimenti, Paola Cipriani, Emmanuel Coloma, Fabrizio Conti, Salvatore D'Angelo, Salvatore De Vita, Salvatore Di Bartolomeo, Oliver Distler, Andrea Doria, Eugen Feist

Abstract

Autoimmune rheumatic diseases are characterised by an abnormal immune system response, complement activation, cytokines dysregulation and inflammation. In last years, despite many progresses in managing these patients, it has been shown that clinical remission is reached in less than 50% of patients and a personalised and tailored therapeutic approach is still lacking resulting in a significant gap between guidelines and real-world practice. In this context, the need for biomarkers facilitating early diagnosis and profiling those individuals at the highest risk for a poor outcome has become of crucial interest. A biomarker generally refers to a measured characteristic which may be used as an indicator of some biological state or condition. Three different types of medical biomarkers has been suggested: i. mechanistic markers; ii. clinical disease markers; iii. therapeutic markers. A combination of biomarkers from these different groups could be used for an ideal more accurate diagnosis and treatment. However, although a growing body of evidence is focused on improving biomarkers, a significant amount of this information is not integrated on standard clinical care.

The overarching aim of this work was to clarify the meaning of specific biomarkers during autoimmune diseases; their possible role in confirming diagnosis, predicting outcome and suggesting specific treatments.

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