TY - JOUR
T1 - Association between type I interferon pathway activation and clinical outcomes in rheumatic and musculoskeletal diseases
T2 - a systematic literature review informing EULAR points to consider
AU - Rodríguez-Carrio, Javier
AU - Burska, Agata
AU - Conaghan, P. G.
AU - Dik, Willem A.
AU - Biesen, Robert
AU - Eloranta, Maija Leena
AU - Cavalli, Giulio
AU - Visser, Marianne
AU - Boumpas, Dimitrios T.
AU - Bertsias, George
AU - Wahren-Herlenius, Marie
AU - Rehwinkel, Jan
AU - Frémond, Marie Louise
AU - Crow, Mary K.
AU - Ronnblom, Lars
AU - Vital, Ed
AU - Versnel, Marjan
N1 - Funding Information:
This work was funded by EULAR (grant no SCI019). PGC and EV are supported in part by the UK National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
PY - 2023/3/7
Y1 - 2023/3/7
N2 - Background Type I interferons (IFN-I) contribute to a broad range of rheumatic and musculoskeletal diseases (RMDs). Compelling evidence suggests that the measurement of IFN-I pathway activation may have clinical value. Although several IFN-I pathway assays have been proposed, the exact clinical applications are unclear. We summarise the evidence on the potential clinical utility of assays measuring IFN-I pathway activation. Methods A systematic literature review was conducted across three databases to evaluate the use of IFN-I assays in diagnosis and monitor disease activity, prognosis, response to treatment and responsiveness to change in several RMDs. Results Of 366 screened, 276 studies were selected that reported the use of assays reflecting IFN-I pathway activation for disease diagnosis (n=188), assessment of disease activity (n=122), prognosis (n=20), response to treatment (n=23) and assay responsiveness (n=59). Immunoassays, quantitative PCR (qPCR) and microarrays were reported most frequently, while systemic lupus erythematosus (SLE), rheumatoid arthritis, myositis, systemic sclerosis and primary Sjögren's syndrome were the most studied RMDs. The literature demonstrated significant heterogeneity in techniques, analytical conditions, risk of bias and application in diseases. Inadequate study designs and technical heterogeneity were the main limitations. IFN-I pathway activation was associated with disease activity and flare occurrence in SLE, but their incremental value was uncertain. IFN-I pathway activation may predict response to IFN-I targeting therapies and may predict response to different treatments. Conclusions Evidence indicates potential clinical value of assays measuring IFN-I pathway activation in several RMDs, but assay harmonisation and clinical validation are urged. This review informs the EULAR points to consider for the measurement and reporting of IFN-I pathway assays.
AB - Background Type I interferons (IFN-I) contribute to a broad range of rheumatic and musculoskeletal diseases (RMDs). Compelling evidence suggests that the measurement of IFN-I pathway activation may have clinical value. Although several IFN-I pathway assays have been proposed, the exact clinical applications are unclear. We summarise the evidence on the potential clinical utility of assays measuring IFN-I pathway activation. Methods A systematic literature review was conducted across three databases to evaluate the use of IFN-I assays in diagnosis and monitor disease activity, prognosis, response to treatment and responsiveness to change in several RMDs. Results Of 366 screened, 276 studies were selected that reported the use of assays reflecting IFN-I pathway activation for disease diagnosis (n=188), assessment of disease activity (n=122), prognosis (n=20), response to treatment (n=23) and assay responsiveness (n=59). Immunoassays, quantitative PCR (qPCR) and microarrays were reported most frequently, while systemic lupus erythematosus (SLE), rheumatoid arthritis, myositis, systemic sclerosis and primary Sjögren's syndrome were the most studied RMDs. The literature demonstrated significant heterogeneity in techniques, analytical conditions, risk of bias and application in diseases. Inadequate study designs and technical heterogeneity were the main limitations. IFN-I pathway activation was associated with disease activity and flare occurrence in SLE, but their incremental value was uncertain. IFN-I pathway activation may predict response to IFN-I targeting therapies and may predict response to different treatments. Conclusions Evidence indicates potential clinical value of assays measuring IFN-I pathway activation in several RMDs, but assay harmonisation and clinical validation are urged. This review informs the EULAR points to consider for the measurement and reporting of IFN-I pathway assays.
KW - arthritis, rheumatoid
KW - autoimmunity
KW - cytokines
KW - immune system diseases
KW - lupus erythematosus, systemic
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U2 - 10.1136/rmdopen-2022-002864
DO - 10.1136/rmdopen-2022-002864
M3 - Article
C2 - 36882218
AN - SCOPUS:85149596915
SN - 2056-5933
VL - 9
JO - RMD Open
JF - RMD Open
IS - 1
M1 - e002864
ER -