Patient-tailored therapy in rheumatoid arthritis: an editorial review

被引:25
作者
Scherer, Hans U. [1 ]
Doerner, Thomas [1 ]
Burmester, Gerd R. [1 ]
机构
[1] Charite, Dept Rheumatol & Clin Immunol, D-10117 Berlin, Germany
关键词
biologic therapy; methotrexate; patient-tailored therapy; personalized medicine; rheumatoid arthritis; TUMOR-NECROSIS-FACTOR; FACTOR-ALPHA GENE; CITRULLINATED PEPTIDE ANTIBODIES; SINGLE-NUCLEOTIDE POLYMORPHISMS; CLINICAL PHARMACOGENETIC MODEL; ANTI-TNF TREATMENT; METHOTREXATE TREATMENT; DOUBLE-BLIND; PERSONALIZED MEDICINE; PROMOTER POLYMORPHISM;
D O I
10.1097/BOR.0b013e328337b832
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Purpose of review The list of therapeutic targets for the treatment of rheumatic diseases constantly grows. As a consequence, a growing number of agents that are specifically directed against these targets become clinically available. However, the more diverse (and expensive) the armamentarium, the more its use should be guided by informed decisions for an optimal treatment. Such personalized, patient-tailored therapy is still not a reality in rheumatology practice. However, several important steps have recently been made towards achievement of this important goal. Recent findings On the basis of the multifactorial nature of the pathogenesis of rheumatic diseases, the quest for single biomarkers that predict treatment response has proven difficult. Instead, biomarker signatures derived from genetic and proteomic expression studies using various biomaterials are being identified and demonstrate predictive value. Research focus has so far been placed on treatment responses to methotrexate and tumor necrosis factor antagonists, but interesting findings are already available for other agents as well. Summary Although still in their infancy in rheumatology, personalized treatment approaches offer the potential for improved safety and efficacy for the patient and ultimately have promises to reduce societal costs.
引用
收藏
页码:237 / 245
页数:9
相关论文
共 92 条
[1]
The relationship of FcγRIIIa genotype to degree of B cell depletion by rituximab in the treatment of systemic lupus erythematosus [J].
Anolik, JH ;
Campbell, D ;
Felgar, RE ;
Young, F ;
Sanz, I ;
Rosenblatt, J ;
Looney, RJ .
ARTHRITIS AND RHEUMATISM, 2003, 48 (02) :455-459
[2]
Anti-adalimumab antibodies in rheumatoid arthritis patients are associated with interleukin-10 gene polymorphisms [J].
Bartelds, G. M. ;
Wijbrandts, C. A. ;
Nurmohamed, M. T. ;
Wolbink, G. J. ;
de Vries, N. ;
Tak, P. P. ;
Dijkmans, B. A. C. ;
Crusius, J. B. A. ;
van der Horst-Bruinsma, I. E. .
ARTHRITIS AND RHEUMATISM, 2009, 60 (08) :2541-2542
[3]
High IgA rheumatoid factor levels are associated with poor clinical response to tumour necrosis factor a inhibitors in rheumatoid arthritis [J].
Bobbio-Pallavicini, Francesca ;
Caporali, Roberto ;
Alpini, Claudia ;
Avalle, Stefano ;
Epis, Oscar M. ;
Klersy, Catherine ;
Montecucco, Carlomaurizio .
ANNALS OF THE RHEUMATIC DISEASES, 2007, 66 (03) :302-307
[4]
Investigation of genetic variants within candidate genes of the TNFRSF1B signalling pathway on the response to anti-TNF agents in a UK cohort of rheumatoid arthritis patients [J].
Bowes, John D. ;
Potter, Catherine ;
Gibbons, Laura J. ;
Hyrich, Kimme ;
Plant, Darren ;
Morgan, Ann W. ;
Wilson, Anthony G. ;
Isaacs, John D. ;
Worthington, Jane ;
Barton, Anne .
PHARMACOGENETICS AND GENOMICS, 2009, 19 (04) :319-323
[5]
An update on methotrexate [J].
Braun, Juergen ;
Rau, Rolf .
CURRENT OPINION IN RHEUMATOLOGY, 2009, 21 (03) :216-223
[6]
Braun-Moscovici Y, 2006, J RHEUMATOL, V33, P497
[7]
Bridges SL, 2007, BULL HOSP JT DIS, V65, P174
[8]
Therapy of patients with rheumatoid arthritis: Outcome of infliximab failures switched to etanercept [J].
Buch, Maya H. ;
Bingham, Sarah J. ;
Bejarano, Victoria ;
Bryer, Domini ;
White, Jo ;
Emery, Paul ;
Reece, Richard ;
Quinn, Mark .
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2007, 57 (03) :448-453
[9]
C-reactive protein as a predictor of infliximab treatment outcome in patients with rheumatoid arthritis - Defining subtypes of nonresponse and subsequent response to etanercept [J].
Buch, MH ;
Seto, Y ;
Bingham, SJ ;
Bejarano, V ;
Bryer, D ;
White, J ;
Emery, P .
ARTHRITIS AND RHEUMATISM, 2005, 52 (01) :42-48
[10]
The performance of anti-cyclic citrullinated peptide antibodies in predicting the severity of radiologic damage in inflammatory polyarthritis - Results from the Norfolk arthritis register [J].
Bukhari, M. ;
Thomson, W. ;
Naseem, H. ;
Bunn, D. ;
Silman, A. ;
Symmons, D. ;
Barton, A. .
ARTHRITIS AND RHEUMATISM, 2007, 56 (09) :2929-2935