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Review
. 2021 Dec 23:12:755844.
doi: 10.3389/fimmu.2021.755844. eCollection 2021.

Toward Overcoming Treatment Failure in Rheumatoid Arthritis

Zhuqian Wang  1   2   3 , Jie Huang  1 , Duoli Xie  2   3 , Dongyi He  4   5 , Aiping Lu  2   3   4   6 , Chao Liang  1   2   3
Affiliations
Review

Toward Overcoming Treatment Failure in Rheumatoid Arthritis

Zhuqian Wang et al. Front Immunol. .

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.

Keywords: DMARDs; biomarker; precision medicine; rheumatoid arthritis; treatment failure.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Comparison between traditional therapy and precision medicine.
See this image and copyright information in PMC

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