scholarly journals Early Prediction of Clinical Response to Etanercept Treatment in Juvenile Idiopathic Arthritis Using Machine Learning

2020 ◽  
Vol 11 ◽  
Author(s):  
Xiaolan Mo ◽  
Xiujuan Chen ◽  
Chifong Ieong ◽  
Song Zhang ◽  
Huiyi Li ◽  
...  
2010 ◽  
Vol 37 (3) ◽  
pp. 665-667 ◽  
Author(s):  
MARIEKE H. OTTEN ◽  
FEMKE H.M. PRINCE ◽  
MARINKA TWILT ◽  
MARION A.J. van ROSSUM ◽  
WINEKE ARMBRUST ◽  
...  

Objective.To evaluate response in patients with juvenile idiopathic arthritis (JIA) who failed to meet response criteria after 3 months of etanercept treatment.Methods.This was a prospective ongoing multicenter observational study of all Dutch patients with JIA using etanercept. Response according to American College of Rheumatology Pediatric 30 criteria was assessed at study start and at 3 and 15 months.Results.In total we studied 179 patients of median age 5.8 years at disease onset; 70% were female. Thirty-four patients did not respond after 3 months, of which 20 continued etanercept and 11 achieved response thereafter.Conclusion.The delayed clinically relevant response in a substantial proportion of patients who initially did not respond justifies the consideration of continuing therapy to at least 6 months.


2020 ◽  
Vol 15 ◽  
Author(s):  
Elham Shamsara ◽  
Sara Saffar Soflaei ◽  
Mohammad Tajfard ◽  
Ivan Yamshchikov ◽  
Habibollah Esmaili ◽  
...  

Background: Coronary artery disease (CAD) is an important cause of mortality and morbidity globally. Objective : The early prediction of the CAD would be valuable in identifying individuals at risk, and in focusing resources on its prevention. In this paper, we aimed to establish a diagnostic model to predict CAD by using three approaches of ANN (pattern recognition-ANN, LVQ-ANN, and competitive ANN). Methods: One promising method for early prediction of disease based on risk factors is machine learning. Among different machine learning algorithms, the artificial neural network (ANN) algo-rithms have been applied widely in medicine and a variety of real-world classifications. ANN is a non-linear computational model, that is inspired by the human brain to analyze and process complex datasets. Results: Different methods of ANN that are investigated in this paper indicates in both pattern recognition ANN and LVQ-ANN methods, the predictions of Angiography+ class have high accuracy. Moreover, in CNN the correlations between the individuals in cluster ”c” with the class of Angiography+ is strongly high. This accuracy indicates the significant difference among some of the input features in Angiography+ class and the other two output classes. A comparison among the chosen weights in these three methods in separating control class and Angiography+ shows that hs-CRP, FSG, and WBC are the most substantial excitatory weights in recognizing the Angiography+ individuals although, HDL-C and MCH are determined as inhibitory weights. Furthermore, the effect of decomposition of a multi-class problem to a set of binary classes and random sampling on the accuracy of the diagnostic model is investigated. Conclusion : This study confirms that pattern recognition-ANN had the most accuracy of performance among different methods of ANN. That’s due to the back-propagation procedure of the process in which the network classify input variables based on labeled classes. The results of binarization show that decomposition of the multi-class set to binary sets could achieve higher accuracy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pratyusha Rakshit ◽  
Onintze Zaballa ◽  
Aritz Pérez ◽  
Elisa Gómez-Inhiesto ◽  
Maria T. Acaiturri-Ayesta ◽  
...  

AbstractThis paper presents a novel machine learning approach to perform an early prediction of the healthcare cost of breast cancer patients. The learning phase of our prediction method considers the following two steps: (1) in the first step, the patients are clustered taking into account the sequences of actions undergoing similar clinical activities and ensuring similar healthcare costs, and (2) a Markov chain is then learned for each group to describe the action-sequences of the patients in the cluster. A two step procedure is undertaken in the prediction phase: (1) first, the healthcare cost of a new patient’s treatment is estimated based on the average healthcare cost of its k-nearest neighbors in each group, and (2) finally, an aggregate measure of the healthcare cost estimated by each group is used as the final predicted cost. Experiments undertaken reveal a mean absolute percentage error as small as 6%, even when half of the clinical records of a patient is available, substantiating the early prediction capability of the proposed method. Comparative analysis substantiates the superiority of the proposed algorithm over the state-of-the-art techniques.


Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 122
Author(s):  
Ruggiero Seccia ◽  
Silvia Romano ◽  
Marco Salvetti ◽  
Andrea Crisanti ◽  
Laura Palagi ◽  
...  

The course of multiple sclerosis begins with a relapsing-remitting phase, which evolves into a secondarily progressive form over an extremely variable period, depending on many factors, each with a subtle influence. To date, no prognostic factors or risk score have been validated to predict disease course in single individuals. This is increasingly frustrating, since several treatments can prevent relapses and slow progression, even for a long time, although the possible adverse effects are relevant, in particular for the more effective drugs. An early prediction of disease course would allow differentiation of the treatment based on the expected aggressiveness of the disease, reserving high-impact therapies for patients at greater risk. To increase prognostic capacity, approaches based on machine learning (ML) algorithms are being attempted, given the failure of other approaches. Here we review recent studies that have used clinical data, alone or with other types of data, to derive prognostic models. Several algorithms that have been used and compared are described. Although no study has proposed a clinically usable model, knowledge is building up and in the future strong tools are likely to emerge.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1451.3-1451
Author(s):  
K. Kraev ◽  
M. Geneva-Popova ◽  
S. Popova

Background:Biological drugs are protein derivatives that, as such, are highly immunogenic. In recent years there have been many conflicting opinions about the role of drug immunogenicity in clinical practice.Objectives:To evaluate the drug immunogenicity of TNF-alpha blocking drugs (etanercept and adalimumab) used to treat patients with rheumatoid arthritis. To determine whether their presence can alter the effect of treatment and to evaluate their role in the clinical practice of rheumatologists.Methods:121 patients with rheumatoid arthritis, as well as 31 healthy controls, similar in sex and age, were examined. They were all monitored at 0, 6, 12 and 24 months from the start of TNF-alpha blocker treatment. Demographics, vital signs, markers of inflammation such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and disease activity indices were examined at each visit, respectively. Drug-induced neutralizing antibodies, as well as drug bioavailability in patients treated with adalimumab, were examined by ELISA.Results:Drug-induced neutralizing antibodies to adalimumab were detected in 11.57% of patients at 6 month, in 17.64% of patients at 12 month, and 24.8% at 24 month. Drug-induced neutralizing antibodies to etanercept were not detected at 6 months, at 7.77% at 12 months, at 9.63% of patients at 24 months. Of the adalimumab patients who were having drug-induced antibodies, 92.59% had low drug bioavailability, while the remaining 7.41% of patients showed normal drug bioavailability despite the presence of drug-induced neutralizing antibodies. In terms of worsening of the disease activity, a positive correlation was found with the presence of drug antibodies - Pearson Correlation = 0.701, p = 0.001. Patients with poor clinical response and available drug antibodies receiving adalimumab were slightly more than those treated with etanercept at 12 and 24 months but the difference is non-significant-U = 0.527, p> 0.05 and U = 0.623, p> 0.05, respectively.Conclusion:Presence of drug-induced neutralizing antibodies in patients treated with adalimumab and etanercept has been associated with poor clinical response and worsening of the patient’s condition. Testing of drug-induced neutralizing antibodies as well as the drug bioavailability of the drug used can be used as reliable biomarkers in clinical rheumatology.References:[1]Benucci M., F.Li Gobbi, M. Meacii et al., “Antidrug antibodies against TNF-blocking agents: correlations between disese activity, hypersensitivity reactions, and different classes of immunoglobulins”, Biologics and Targets and Therapy, 2015: 9 7 -2.[2]Chen D., Y. Chen, W. Tsai et al., “ Significant associations of antidrug antibody levels with serum drug trough levels and therapeutic response of adalimumab and etanercept treatment in rheumatoid arthritis”, Ann Rheum Dis. 2015 Mar; 74 (3).[3]Kalden J. and H. Schulze-Koops, “ Immunogenicity and loss of response to TNF inhibitors: implications for rheumatoid arthritis treatment ”, Nature Reviews Rheumatology, 2017 volume 13, 707–718.[4]Wolf-Henning Boehnck, N. Brembilla, “ Immunogenicity of biological therapies: causes and consequences, ” Expert Review of Clinical Immunology, Vol 14, 2018, Issue 6, 513-523Disclosure of Interests:None declared


2019 ◽  
Vol 78 (5) ◽  
pp. 617-628 ◽  
Author(s):  
Erika Van Nieuwenhove ◽  
Vasiliki Lagou ◽  
Lien Van Eyck ◽  
James Dooley ◽  
Ulrich Bodenhofer ◽  
...  

ObjectivesJuvenile idiopathic arthritis (JIA) is the most common class of childhood rheumatic diseases, with distinct disease subsets that may have diverging pathophysiological origins. Both adaptive and innate immune processes have been proposed as primary drivers, which may account for the observed clinical heterogeneity, but few high-depth studies have been performed.MethodsHere we profiled the adaptive immune system of 85 patients with JIA and 43 age-matched controls with indepth flow cytometry and machine learning approaches.ResultsImmune profiling identified immunological changes in patients with JIA. This immune signature was shared across a broad spectrum of childhood inflammatory diseases. The immune signature was identified in clinically distinct subsets of JIA, but was accentuated in patients with systemic JIA and those patients with active disease. Despite the extensive overlap in the immunological spectrum exhibited by healthy children and patients with JIA, machine learning analysis of the data set proved capable of discriminating patients with JIA from healthy controls with ~90% accuracy.ConclusionsThese results pave the way for large-scale immune phenotyping longitudinal studies of JIA. The ability to discriminate between patients with JIA and healthy individuals provides proof of principle for the use of machine learning to identify immune signatures that are predictive to treatment response group.


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