When PrismRA can help guide treatment decisions: intended use & case study examples

For patients with rheumatoid arthritis (RA), ineffective early treatment increases the likelihood of surgery, irreversible joint damage, and chronic pain.1 Prior to PrismRA, rheumatologists lacked personalized guidance to optimize therapy selection based on their patients’ disease biology.

PrismRA is a blood-based, precision medicine test that predicts inadequate response to tumor necrosis factor-α inhibitor (TNFi) therapies prior to treatment initiation to improve upon the trial-and-error approach to treatment selection.

Intended Use

PrismRA is intended to be used by the treating physician when considering starting, adjusting the dose of, or switching to a TNFi therapy in patients who meet the following criteria:

Intended Use PrismRA

Click here to read the PrismRA Technical Specifications.

Seeing PrismRA in Practice

Case Study #1

PrismRA has been ordered by ~1,500 rheumatology specialists across the US, helping them guide their treatment decisions for patients with RA in moderate or high disease activity. Here are a couple of examples of how the test is being used and the results that patients are experiencing after following the test results.

PrismRA Result: High Inadequate Response Signature Detected

The patient above is a 67-year-old female who had been newly diagnosed with RA. After 8 months on methotrexate (MTX) it was clear that she needed additional therapy to get her disease under control. Her physician ordered PrismRA which detected a signature of inadequate response to TNFi therapy. At her next appointment at the 11-month mark, she started on tocilizumab (an IL-6) which helped significantly improve her disease activity.

While the most common care pathway would include starting a TNFi after failing MTX, the PrismRA result for this patient indicated she was unlikely to respond to that therapy choice. Deciding to put her on tocilizumab instead of a TNFi helped her reach low disease activity quickly and continue doing well during subsequent follow up appointments, improving her quality of life and reducing other risks.

Case Study #2

This next patient is a 25-year-old female who was diagnosed when she was just 22 years old. As her symptoms progressed, she and her physician decided to try biologic treatment with adalimumab as her first-line biologic. After 1 month, she had developed synovitis on her hands and was very unhappy. Her rheumatologist talked to her about PrismRA and after receiving her results it was clear why the adalimumab had not worked for her – her PrismRA result showed she had an inadequate response signature to TNFi detected. After switching her therapy over to abatacept (a T-Cell), she found much more relief.

Patient Follow-Up

  • Patient was skeptical of treatment options but tried Humira
  • After 1 month iwth no efficacy, patient developed synovitis on her hands and was considering transferring her care to another practice
  • Skeptical in general and hesitant to try and additional treatment with more side effects
  • Willing to try PrismRA to inform the selection of her next therapy

PrismRA Result: Inadequate Response Signature Detected

Treatment Decision & Outcome

  • Despite continued skepticism, willing to start Orencia immediately
  • Within 2 infusions, her symptoms dramatically improved
  • Her life had completely changed and was truly optimistic about her future

In Conclusion

PrismRA is a first-of-its kind precision medicine laboratory test designed to help guide treatment decisions for patients with rheumatoid arthritis. The test can help shorten the trial-and-error treatment process by predicting if a patient will have an inadequate response to a TNFi.

The earlier the test is used in a patient’s journey with RA, specifically when they are considering moving to a b/tsDMARD, the more likely the patient is to find an effective treatment and reach their treatment goals quickly.

Here are the boxes to check when considering testing a patient with PrismRA:

  • The patient must be over 18 and have a diagnosis of rheumatoid arthritis
  • The patient must be in moderate or high disease activity
  • The patient is considering starting a b/tsDMARD OR they have been using a TNFi and are considering a dose change or switch to an alternative MOA.

1. Creaky Joints: RA Testing Patient Guideline. https://creakyjoints.org//www/wp-content/uploads/CreakyJoints_RA_Testing_Patient_Guideline.pdf. Accessed 11/1/22.   

Learn More About PrismRA

Interested in how PrismRA helps guide therapy decisions? Please contact the Scipher Medicine Client Services team.

Email IconSupport@Scipher.com

Phone Icon855-724-7437

author avatar
Stu Steene-Connelly