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Mechanistic biomarkers for clinical decision making in rheumatic diseases
Open accessAbstract
The use of biomarkers is becoming increasingly intrinsic to the practice of medicine and holds great promise for transforming the practice of rheumatology. Biomarkers have the potential to aid clinical diagnosis when symptoms are present or to provide a means of detecting early signs of disease when they are not. Some biomarkers can serve as early surrogates of eventual clinical outcomes or guide therapeutic decision making by enabling identification of individuals likely to respond to a specific therapy. Using biomarkers might reduce the costs of drug development by enabling individuals most likely to respond to be enrolled in clinical trials, thereby minimizing the number of participants required. In this Review, we discuss the current use and the potential of biomarkers in rheumatology and in select fields at the forefront of biomarker research. We emphasize the value of different types of biomarkers, addressing the concept of 'actionable' biomarkers, which can be used to guide clinical decision making, and 'mechanistic' biomarkers, a subtype of actionable biomarker that is embedded in disease pathogenesis and, therefore, represents a potentially superior biomarker. We provide examples of actionable and mechanistic biomarkers currently available, and discuss how development of such biomarkers could revolutionize clinical practice and drug development.
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“Multiple cell types, including synoviocytes, chondrocytes, and invading immune cells, synthesize IL-1β in osteoarthritic joints, thereby building a complex network of paracrine and autocrine signals [35].”
From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [35]
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Metadata
- Authors
- Robinson, W. H., Lindstrom, T. M., Cheung, R. K., & Sokolove, J.
- Affiliations
- VA Palo Alto Health Care System (US)
- Stanford Medicine (US)
- Corresponding author
- Robinson, William H.
- Venue
- Nature Reviews Rheumatology
- Published
- 2013-02-19
- Volume
- 9
- Issue
- 5
- Pages
- 267-276
- ISSN
- 1759-4790 (ISSN-L)
- 1759-4804
- PMC
- PMC3673766
- OpenAlex
- W2010417263
- Cited by
- 109
- References
- 107
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 8 · 2020: 12 · 2019: 9 · 2018: 5 · 2017: 12 · 2016: 7 · 2015: 9 · 2014: 11 · 2013: 5
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (N01-HV 00242)
- National Institute of Allergy and Infectious Diseases (U01 U01AI101981, U01AI101981)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (RC1AR058713, R01AR054822)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Life Sciences › Immunology and Microbiology › Immunology › Biomarkers in Disease Mechanisms
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Keywords
- mechanistic biomarkers, actionable biomarkers, rheumatic diseases, clinical decision-making, disease activity, drug development, early diagnosis, treatment response prediction, pathogenesis, clinical trial recruitment
- MeSH terms
- Animals, Decision Making, Humans, Rheumatic Diseases, Rheumatology, Biomarkers
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