Pharmacogenomics in the treatment of rheumatoid arthritis: clinical implication and perspective

Rheumatoid arthritis (RA) is a chronic inflammatory disease. The inflammatory process of the joint destroys articular architecture and causes a significant disability. The efficacy of disease modifying antirheumatic drugs such as methotrexate, sulfasalazine and biological response modifiers, is widely accepted. However, the outcome of the treatment with these agents is known to vary among patients. The application of the pharmacogenomics is expected to reduce toxicities and enhance the desirable effects of therapeutic agents for RA. Recently, pharmacogenomic studies on methotrexate, sulfasalazine and tumor necrosis factor-α inhibitors have been reported. These investigations suggest that the pharmacogenomic approach is useful for the treatment of RA, although there are points to be considered before the translation of the pharmacogenomic data into clinical practice. This review focuses on the latest information on the pharmacogenomics of antirheumatic drugs and its clinical implication in the treatment of RA.