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.