Patient-tailored therapy in rheumatoid arthritis: an editorial 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.

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.

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.