Pharmacogenomics in pediatric rheumatology.
OBJECTIVE
Despite major advancements in therapeutics, variability in drug response remains a challenge in both adults and children diagnosed with rheumatic disease. The genetic contribution to interindividual variability has emerged as a promising avenue of exploration; however, challenges remain in making this knowledge relevant in the clinical realm.


RESULTS
New genetic associations in patients with rheumatic disease have been reported for disease modifying antirheumatic drugs, antimetabolites and biologic drugs. However, many of these findings are in need of replication, and few have taken into account the concept of ontogeny, specific to pediatrics.


CONCLUSIONS
In the current era in which we practice, genetic variation will undoubtedly contribute to variability in therapeutic response and may be a factor that will ultimately impact individualized care. However, preliminary studies have shown that there are many hurdles that need to be overcome as we explore pharmacogenomic associations specifically in the field of pediatric rheumatology.
Division of Clinical Pharmacology and Toxicology, Section of Rheumatology, Children's Mercy Hospital, Kansas City, Missouri, USA. mlbecker@cmh.edu
Mara L
ML
Becker
D000963:Antimetabolites / Q000493:pharmacokinetics / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001379:Azathioprine / Q000493:pharmacokinetics / Q000627:therapeutic use; D001688:Biological Products / Q000493:pharmacokinetics / Q000627:therapeutic use; D002648:Child; D006801:Humans; D008727:Methotrexate / Q000493:pharmacokinetics / Q000627:therapeutic use; D008954:Models, Biological; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D010597:Pharmacogenetics; D057285:Precision Medicine; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism; D012219:Rheumatology
D000963:Antimetabolites; D018501:Antirheumatic Agents; D001688:Biological Products; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate