The lipid profile for the prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis: The HOPE study

OBJECTIVE: To explore the use of lipidomics for prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis. DESIGN: The Hand Osteoarthritis Prednisolone Efficacy (HOPE) study included patients (n ​= ​92) with symptomatic inflammatory hand osteoarthritis, fulfilling the ACR criteria. The present analyses comprised only patients randomized to prednisolone treatment (10 ​mg daily, n ​= ​40). Response to prednisolone treatment was defined according to the OARSI-OMERACT responder criteria at six weeks. Baseline blood samples were obtained non-fasted. Lipid species were quantified in erythrocytes with the Lipidyzer™ platform (Sciex). Oxylipins were analyzed in plasma using an in-house LC-MS/MS platform. Elastic net regularized regression was used to predict prednisolone treatment response based on common patient characteristics alone and including the patients’ lipid profile. ROC analyses with 1000 bootstrapped area under the curve (AUC) was used to determine the discriminatory accuracy of the models. RESULTS: Among included patients, 78% fulfilled the OARSI-OMERACT responder criteria. From the general patient characteristics, elastic net selected baseline hand function as only predictor of treatment response, with an AUC of 0.78 (0.56; 0.97). Addition of lipidomics resulted in an AUC of 0.92 (0.78; 0.99) and 0.85 (0.65; 0.98) for inclusion of the Lipidyzer™ platform and oxylipin platform, respectively. CONCLUSION: Our results suggest that the patients’ lipid profile may improve the discriminative accuracy of the prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis compared to prediction by commonly measured patient characteristics alone. Hence, lipidomics may be a promising field for biomarker discovery for prediction of anti-inflammatory treatment response.