Personalized Medicine - Testing what Drug will Work for You
Several years ago our contributor Andrew wrote this article on the need for tests for individualized treatment: https://rheumatoidarthritis.net/living/individualized-diagnostic-tests. Since then the PrismRA, which tests for if anti-TNF drugs are less likely to work has become available. Hopefully other tests for personalized treatments are on the horizon.
Has your doctor ever mentioned the PrismRA test or personalized medicine in general?
I learned about the PrismRA test here. Thank youfor making me aware of it.
I have asked my rheumatologist about it. He dodges the question. At my April appointment he said, "Its not FDA approved." I didn't push the issue and maybe I should have. Even with a daily low dose steroid, I don't have good disease control.
I did a basic search and it appears that only 15% of rheumatologists are using PrismRA.
Has anyone in the community had the test done? Did it prompt a change in your treatment?
, I'm not Medicare eligible yet but found it interesting that Medicare will pay for the test but my rheumatologist didn't provide any information. As his practice and waiting list grows, he has become more of a medication dispenser but that's a story for another day.
When I followed the healio link you provided, I found it discouraging that the test is used for people who have not been on a biologic. So many of us have been on several. At least I think I read that correctly. But the Prism test does hold a lot of promise for those who have not been on a biologic.
I sure appreciate the solid information your provide us!Hi
. I suspect that the reason it is noted about use for those who have not tried a biologic is because RA patients are almost always started on a anti-TNF, so, for those already on a biologic. It is likely they are getting first hand knowledge of the effectiveness. I actually find this short-sighted because a Embrel may not work for a person while Humira does, but the PrismRA test could potentially rule out all anti-TNFs. This actually raises a different issue. RA patients tend to start biologics with anti-TNFs because they were the first and doctors are most used to them. However, there is plenty of research finding other biologics more effective. See for example this paper which states "Head-to-head randomized controlled trials (RCTs) in biologic-naïve RA patients with high disease activity and inadequate response/intolerance to methotrexate have shown interleukin-6 receptor inhibitors (IL-6Ri) to be superior to tumor necrosis factor inhibitors (TNFi) as monotherapy:" https://pmc.ncbi.nlm.nih.gov/articles/PMC10345054. The goal of the precision medicine needs to be finding the best medication for the individual quickly, without the trial and error. Best, Richard (Team Member)
