Personalized medicine in rheumatoid arthritis: hopes and challenges.
Clinicians have an increasing number of therapeutic agents available for the treatment of rheumatoid arthritis (RA). Pharmacogenetics, the study of genetic variation underlying differential response to drugs, seeks to improve treatment of individual patients. Multiple markers of treatment response have been analyzed in RA, but many of the studies are small and retrospective in nature. There are many obstacles to personalized medicine for RA patients, including incomplete understanding of disease pathogenesis, effecting changes in physician behavior, and acceptance of costs by health insurers. Despite these many obstacles, there are many reasons for optimism for future personalized medicine in RA. There have been remarkable advances in genomics, proteomics, and statistical analyses of large amounts of data. The goal of identifying genetic, serum, and clinical factors that allow profiling of individual patients to predict optimal treatment regimens is a worthy pursuit which will hopefully improve clinical care of RA patients.
Bridges
S Louis
SL
Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham 35294, USA. lbridges@uab.es
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics* / Q000276:immunology; D004351:Drug Resistance; D005819:Genetic Markers; D005838:Genotype; D006801:Humans; D008780:Methyltransferases / Q000235:genetics; D010597:Pharmacogenetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics
D018501:Antirheumatic Agents; D005819:Genetic Markers; D014409:Tumor Necrosis Factor-alpha; D008780:Methyltransferases; C022745:thiopurine methyltransferase