Biomarkers have been used in lupus to help physicians better monitor disease status, treat flare-ups before they occur, and determine which treatments will work best in each patient and when to use them, says William V. Williams, MD, FACP, president and CEO, BriaCell Therapeutics Corp., which develops novel immunotherapies to fight cancer; and adjunct professor of medicine, University of Pennsylvania, Philadelphia. They may also indicate if a treatment is working or producing side effects before they become apparent from how the patient looks and feels.
Some biomarkers, known as anti-nuclear antibodies (ANAs), help physicians figure out what type of lupus a patient has—since many types exist, Williams says. This helps physicians to make treatment decisions and also helps them to figure out which organs (such as the kidneys or skin) might become affected by the disease.
Biomarkers increase patients’ quality of care by anticipating flare-ups. Markers of inflammation, called “complement” components, go up and down in blood tests depending upon inflammation levels. Sometimes they go down before a lupus flare-up, Williams says, so physicians will treat the patient to prevent a flare-up. This is also true of anti-DNA antibodies, which can increase before a flare-up and decrease when a patient is improving. Newer biomarkers, such as interferon signature biomarkers, help to select which patients will benefit the most from new treatments being developed.
Biomarkers in lupus help reduce healthcare costs by allowing physicians to better monitor patients, providing treatments before the disease becomes too severe—avoiding costly hospitalizations, Williams says. They also help by predicting if a patient is going to have a flare-up, so they can be treated before the disease gets so severe that the patient has to be hospitalized or develops kidney failure and has to go on dialysis.