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An update on pharmacogenomics in rheumatoid arthritis with a focus on TNF-blocking agents

Prabha Ranganathan1

  • 1Washington University School of Medicine, Department of Medicine, Division of Rheumatology, St Louis, MO 63110, USA. prangana@im.wustl.edu

Current Opinion in Molecular Therapeutics
|December 4, 2008
PubMed

Insights

Identifying genetic markers for rheumatoid arthritis (RA) treatment response is crucial. Pharmacogenomics may predict efficacy of anti-tumor necrosis factor (TNF) therapies, but more research is needed.

Area of Science:

  • Immunology
  • Rheumatology
  • Genetics

Background:

  • Tumor necrosis factor-alpha (TNFalpha) is key in rheumatoid arthritis (RA) pathogenesis.
  • Anti-TNF biologic therapies are effective but costly, with variable patient response rates.
  • Predicting response to anti-TNF agents is essential for personalized RA treatment.

Purpose of the Study:

  • To review the role of pharmacogenomics in predicting response to anti-TNF therapies in RA.
  • To evaluate the predictive potential of genetic polymorphisms in RA patients undergoing anti-TNF treatment.

Main Methods:

  • Review of studies investigating genetic polymorphisms related to TNFalpha, MHC region, and Fcgamma receptor IIIA.
  • Analysis of the association between these polymorphisms and RA disease progression and anti-TNF therapy response.

Main Results:

  • Several genetic polymorphisms have been studied for their potential to predict RA disease progression and response to anti-TNF therapies.
  • Current evidence does not establish a consensus on the utility of pharmacogenomics for predicting anti-TNF therapy efficacy in RA.

Conclusions:

  • Pharmacogenomic approaches show promise for personalizing anti-TNF therapy in RA.
  • Large, prospective, multicenter studies are required to validate existing findings and establish clinical utility.

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