Vantage Research Inc, Lewes, Lewes, DE, USA.
NPJ Syst Biol Appl. 2024 Nov 4;10(1):126. doi: 10.1038/s41540-024-00454-1.
Rheumatoid Arthritis (RA) is a chronic autoimmune inflammatory disease that affects about 0.1% to 2% of the population worldwide. Despite the development of several novel therapies, there is only limited benefit for many patients. Thus, there is room for new approaches to improve response to therapy, including designing better trials e.g., by identifying subpopulations that can benefit from specific classes of therapy and enabling reverse translation by analyzing completed clinical trials. We have developed an open-source, mechanistic multi-scale model of RA, which captures the interactions of key immune cells and mediators in an inflamed joint. The model consists of a treatment-naive Virtual Population (Vpop) that responds appropriately (i.e. as reported in clinical trials) to standard-of-care treatment options-Methotrexate (MTX) and Adalimumab (ADA, anti-TNF-α) and an MTX inadequate responder sub-population that responds appropriately to Tocilizumab (TCZ, anti-IL-6R) therapy. The clinical read-outs of interest are the American College of Rheumatology score (ACR score) and Disease Activity Score (DAS28-CRP), which is modeled to be dependent on the physiological variables in the model. Further, we have validated the Vpop by predicting the therapy response of TCZ on ADA Non-responders. This paper aims to share our approach, equations, and code to enable community evaluation and greater adoption of mechanistic models in drug development for autoimmune diseases.
类风湿性关节炎(RA)是一种慢性自身免疫性炎症性疾病,影响全球约 0.1%至 2%的人口。尽管开发了几种新的治疗方法,但许多患者的受益仍然有限。因此,需要新的方法来提高治疗反应,包括设计更好的试验,例如通过确定可以从特定治疗类别中受益的亚人群,并通过分析已完成的临床试验来实现反向翻译。我们开发了一种开源的、基于机制的 RA 多尺度模型,该模型捕捉了炎症关节中关键免疫细胞和介质的相互作用。该模型由一个未经治疗的虚拟人群(Vpop)组成,该人群对标准治疗方案(即临床试验中报告的)、甲氨蝶呤(MTX)和阿达木单抗(ADA,抗 TNF-α)有适当的反应,以及一个 MTX 治疗反应不足的亚人群,对托珠单抗(TCZ,抗 IL-6R)治疗有适当的反应。感兴趣的临床指标是美国风湿病学会评分(ACR 评分)和疾病活动评分(DAS28-CRP),该评分依赖于模型中的生理变量。此外,我们通过预测 TCZ 对 ADA 无应答者的治疗反应来验证了 Vpop。本文旨在分享我们的方法、方程和代码,以促进社区评估,并在自身免疫性疾病的药物开发中更广泛地采用基于机制的模型。
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