Our precision-focused approach in rheumatoid arthritis and beyond: a Q&A with Dr. Sean E. Connolly

What are we talking about when we say “biomarker” in immune-mediated diseases, and why are these important?

In the simplest terms, a “biomarker” is any measurable indicator of a biological process. In immune-mediated diseases, one major reason we look at biomarkers is because they can help us identify patients and tell us something about their potential future disease progression.

Take rheumatoid arthritis (RA), for example, an immune-mediated disease that causes joint damage with chronic pain, stiffness and swelling of joints. The effects of RA extend beyond the musculoskeletal symptoms of chronic pain and physical disability, with the potential to include: fatigue, anxiety, depression, respiratory, gastrointestinal, and cardiovascular disease, economic burden, reduced quality of life, and increased mortality.

RA can present and behave very differently in different individuals. Some people with rheumatoid arthritis have a more highly active and progressive form of the disease that can lead to worse outcomes, making an early diagnosis and treatment particularly critical. It was discovered a number of years ago that these patients frequently test positive for a biomarker called anti-citrullinated protein antibody, or ACPA. ACPA can be detected in a person’s bloodstream before joint damage becomes clinically apparent. Knowing that a patient is ACPA positive can therefore give the physician (and the patient) helpful, predictive information right from the start.

Bristol Myers Squibb research has advanced understanding of the impact of ACPA positivity in RA and continues to investigate the correlation between this biomarker and outcomes like joint erosion. We also recently developed a video to help raise awareness about biomarkers in RA, because it’s important for health care professionals and patients alike to understand that these tools are out there:

How else can RA biomarkers like ACPA be used?

Another reason studying biomarkers is important is that they can serve as targets for future therapy development. Bristol Myers Squibb research is currently focused on how RA patients who are ACPA positive respond to existing treatments. Down the line, this and other biomarkers may help guide development of medicines with new mechanisms of action.

How is Bristol Myers Squibb applying these insights to other immune-mediated disease research?

What’s fascinating about biomedical research is you never know where a certain finding might lead you, or how insights may build on each other, or even take on new life in a different therapeutic area. As scientists first began to examine T-cell involvement and immunotherapy in cancer, Bristol Myers Squibb research in RA also was already demonstrating the impact of these approaches. Immunotherapies in immune-mediated diseases and cancer are really two sides of the same coin: turning down the immune response in the former case, and turning it up in the latter.

Bristol Myers Squibb has deep, long-standing expertise in discovering and developing medicines designed to help modulate the body’s immune response to treat immune-mediated diseases and cancer, and we’re pursuing a breadth of additional research. Our Immunology aspirations include delivering life-changing medicines for patients with immune-mediated diseases where innovations are needed.

On a personal note, what is your hope for patients facing immune-mediated diseases?

It’s a common refrain these days because of where genomics research is headed, but the ultimate goal with our research is to help advance personalized medicine approaches in immune-mediated diseases. We envision a scenario where a patient will be able to understand his or her own unique profile – how their disease is likely to progress and which treatments are most likely to help them – and their physician will be able to match that profile with the right medicine for them, at the right time. We want people impacted by immune-mediated diseases to know there are many dedicated people at Bristol Myers Squibb working hard every day to hopefully, one day, make this a reality.