[Personalized medicine in cytokine-targeted therapy]

Personalized healthcare tries to predict the effectiveness and safety in individual therapeutic approaches by defining individual patient characteristics (biomarkers), while stratification uses diagnostic patterns for groups of patients for prediction of therapeutic response with less adverse reactions caused by the drugs applied. Both methods are implemented in oncology and infectiology and in the therapy of rheumatological diseases there is a need for both. Cytokine-directed therapies are important for the treatment of rheumatological diseases, especially when therapy with conventional disease-modifying antirheumatic drugs (DMARD) has failed. Despite the high potency of these drugs for inhibiting pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin 1 (IL-1) and IL-6, sufficient responses are only seen in some of the patients. Therefore, stratification and personalized medicine are ways to optimize efficacy and tolerability of biologic therapies. Some initial evidence is available for potential future strategies using molecular and genetic markers for stratified cytokine inhibition.