Rethinking definitions of autoimmune disease
Why autoimmune diseases should be redefined by molecular pathway
The autoimmune field is dialing up its search for better biomarkers as it seeks to make the next step change from the targeted therapies that overtook blanket immunosuppressants. The question is whether autoimmunity might follow the lead of oncology and classify indications by molecular drivers rather than the symptoms or tissues involved.
While TNF-α inhibitors and other therapies targeting specific immune pathways have provided better outcomes for many patients than generalized immunosuppressants such as steroids, there is still no good way to match therapies to patients or disease stage.
For patients, this often means cycling through treatments in a trial-and-error fashion before finding one that works.
For drug developers, it raises the risk of failure as companies have little to guide their patient selection or clinical strategy to optimize outcomes.
“Rheumatoid arthritis is the classic example of the problem across autoimmune disease,” said Christoph Lengauer, president of precision autoimmune start-up Celsius Therapeutics. “Anti-TNF-α is a great drug, but 40% of patients don’t respond. We don’t know how to predict who will respond, when to give it during the course of the disease, or who will have side effects.”
Celsius and Scipher Medicine announced series A rounds this year, and aim