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Toward Overcoming Treatment Failure in Rheumatoid Arthritis
Zhuqian Wang1,2,3, Jie Huang1, Duoli Xie2,3
1Department of Biology, School of Life Sciences, Southern University of Science and Technology, Shenzhen, China.
Abstract:
Rheumatoid arthritis (RA) is an autoimmune disorder characterized by inflammation and bone erosion. The exact mechanism of RA is still unknown, but various immune cytokines, signaling pathways and effector cells are involved. Disease-modifying antirheumatic drugs (DMARDs) are commonly used in RA treatment and classified into different categories. Nevertheless, RA treatment is based on a "trial-and-error" approach, and a substantial proportion of patients show failed therapy for each DMARD. Over the past decades, great efforts have been made to overcome treatment failure, including identification of biomarkers, exploration of the reasons for loss of efficacy, development of sequential or combinational DMARDs strategies and approval of new DMARDs. Here, we summarize these efforts, which would provide valuable insights for accurate RA clinical medication. While gratifying, researchers realize that these efforts are still far from enough to recommend specific DMARDs for individual patients. Precision medicine is an emerging medical model that proposes a highly individualized and tailored approach for disease management. In this review, we also discuss the potential of precision medicine for overcoming RA treatment failure, with the introduction of various cutting-edge technologies and big data.
Insights
Rheumatoid arthritis (RA) treatment faces challenges due to a trial-and-error approach. Precision medicine offers a tailored strategy to improve treatment efficacy for individual patients with RA.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is an autoimmune disease causing inflammation and bone erosion.
- Current RA treatment relies on disease-modifying antirheumatic drugs (DMARDs) but often involves a trial-and-error approach.
- A significant number of patients experience treatment failure with existing DMARDs.
Purpose of the Study:
- To review efforts to overcome RA treatment failure.
- To discuss the potential of precision medicine in RA management.
- To highlight the role of cutting-edge technologies and big data in personalized RA therapy.
Main Methods:
- Literature review of strategies to improve RA treatment efficacy.
- Analysis of biomarker identification and reasons for DMARD loss of efficacy.
- Exploration of sequential/combinational DMARDs and new drug development.
Main Results:
- Past decades have seen efforts in biomarker identification and understanding DMARD efficacy.
- New DMARDs and combination strategies have been developed to combat treatment failure.
- These advancements provide insights but are insufficient for individualized RA medication.
Conclusions:
- Current RA treatment strategies require significant improvement for individual patient needs.
- Precision medicine, leveraging advanced technologies and big data, holds promise for tailored RA management.
- Further research is needed to fully implement precision medicine for effective RA treatment.
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