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Review
. 2021 Jul 29;11(8):1362.
doi: 10.3390/diagnostics11081362.

Precision Medicine for Rheumatoid Arthritis: The Right Drug for the Right Patient-Companion Diagnostics

Richard Thomas Meehan  1 , Isabelle Anne Amigues  1 , Vijaya Knight  2
Affiliations
Review

Precision Medicine for Rheumatoid Arthritis: The Right Drug for the Right Patient-Companion Diagnostics

Richard Thomas Meehan et al. Diagnostics (Basel). .

Abstract

Despite the growing number of biologic and JAK inhibitor therapeutic agents available to treat various systemic autoimmune illnesses, the lack of a validated companion diagnostic (CDx) to accurately predict drug responsiveness for an individual results in many patients being treated for years with expensive, ineffective, or toxic drugs. This review will focus primarily on rheumatoid arthritis (RA) therapeutics where the need is greatest due to poor patient outcomes if the optimum drug is delayed. We will review current FDA-approved biologic and small molecule drugs and why RA patients switch these medications. We will discuss the sampling of various tissues for potential CDx and review early results from studies investigating drug responsiveness utilizing advanced technologies including; multiplex testing of cytokines and proteins, autoantibody profiling, genomic analysis, proteomics, miRNA analysis, and metabolomics. By using these new technologies for CDx the goal is to improve RA patient outcomes and achieve similar successes like those seen in oncology using precision medicine guided therapeutics.

Keywords: RA drug responsiveness biomarker; biologics for RA; biomarkers in RA; companion diagnostic test (CDx); precision therapeutics for RA.

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Conflict of interest statement

The authors declare no conflict of interest. Grant funding to R T Meehan and V Knight are unrelated to this manuscript.

Figures

Figure 1
Figure 1
Results of reasons why RA patients change biologic or small molecule therapy within one academic practice in the US between 2008 and 2016.
See this image and copyright information in PMC

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