Possibilities for personalised medicine in rheumatoid arthritis: hype or hope

Abstract

Knowledge of pathophysiology of rheumatoid arthritis (RA) has improved over the past decades, which resulted in new treatment options and strategies that led to better clinical outcomes. At the same time, we have come to understand that RA is a heterogeneous disease on a clinical as well as a pathophysiological level. Despite this heterogeneity, current management recommendations still adopt a 'one-size-fits-all' treatment approach, where ideally individualised treatment, or personalised medicine, is preferred. The first step towards personalised medicine in RA would be to designate different treatment strategies to distinct clinical or molecular phenotypes of patients. This viewpoint discusses current evidence and elaborates on future possibilities for personalised medicine in RA.

Keywords: arthritis; autoantibodies; rheumatoid; therapeutics.

Figure 1

Current management of (rheumatoid) arthritis versus future possibilities for personalised medicine in (rheumatoid) arthritis. Abbreviations: IL-6, interleukin 6 inhibitor; JAKi, Janus Kinase inhibitor; RA, rheumatoid arthritis; RA−, autoantibody negative RA; RA+, autoantibody positive RA; TNFi, tumour necrosis factor inhibitor; UA, undifferentiated arthritis.