Multiomics Approach Predicts Rheumatoid Arthritis Before First Joint Swelling

By Bio-IT World Staff 

October 22, 2025 | A breakthrough in rheumatoid arthritis (RA) research may redefine how and when the autoimmune disease is diagnosed and treated. Kevin Deane, M.D., Ph.D., professor of medicine at the University of Colorado Anschutz., and his colleagues at the Allen Institute for Immunology and UC San Diego have mapped immune changes that occur years before the first swollen joint appears, offering better prediction of disease progression and detection of the underlying mechanisms driving those progressions. 

Currently, the anti-citrullinated protein antibody (ACPA) test can identify individuals at high risk for RA, but only about one-third of those flagged ever develop the disease. Gary Firestein, M.D., senior associate vice chancellor for health sciences at UC San Diego, noted that better predictive tools could make for shorter studies that require fewer participants, thus reducing cost and improving efficiency for drug developers.  

Their study, published in Science Translational Medicine (DOI: https://doi.org/10.1126/scitranslmed.adt7214), used a multiomics approach that used transcriptome, proteome profiling, and immune cell phenotyping. The data revealed that even immune cells never exposed to antigens undergo reprogramming long before symptoms emerge. “What we found almost appears to be an overactive immune system very early on before people in the study have the actual disease,” said Mark Gillespie, Ph.D., assistant investigator at the Allen Institute in Seattle and a senior author on the study. 

The next phase of research will be to define intercellular communication networks to pinpoint which cells drive inflammation and how they can be reprogrammed before irreversible joint damage occurs. The team is also aiming for diagnostic and treatment alternatives in parallel. As Firestein explained, there is a diversity of responses to highly targeted agents for RA, which implies that there is “no single mechanism of disease in rheumatoid arthritis.” 

Six RA prevention trials have been completed worldwide to date, with some modest successes. The newly available insights about the immune system in individuals who eventually develop RA will help inform the next round of clinical trials. Deane also encouraged data sharing and for others “to ask questions that we maybe haven’t thought of to drive forward discovery in this area.”  

To read the full story written by Deborah Borfitz, head over to Diagnostics World News.