Prediction of Response to Targeted Treatment in Rheumatoid Arthritis

被引:92
作者
Wijbrandts, C. A. [1 ]
Tak, P. P. [2 ,3 ,4 ,5 ]
机构
[1] Med Ctr Slotervaart, Rheumatol Dept, Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands
[3] Univ Cambridge, Cambridge, England
[4] Univ Ghent, Ghent, Belgium
[5] GlaxoSmithKline Res & Dev Ltd, Stevenage, Herts, England
关键词
ANTITUMOR-NECROSIS-FACTOR; CYCLIC CITRULLINATED PEPTIDE; FACTOR-ALPHA THERAPY; BODY-MASS INDEX; SYNOVIAL TISSUE HETEROGENEITY; METHOTREXATE-NAIVE PATIENTS; ANTI-ADALIMUMAB ANTIBODIES; I INTERFERON SIGNATURE; CLINICAL-RESPONSE; DOUBLE-BLIND;
D O I
10.1016/j.mayocp.2017.05.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Rheumatoid arthritis is an autoimmune syndrome presenting with chronic inflammation of the joints. Patients with the same diagnosis can present with different phenotypes. In some patients severe joint inflammation and early joint destruction are observed, whereas a milder phenotype can be seen in others. Conversely, patients with the same signs and symptoms may exhibit different immunological and molecular abnormalities. Since the introduction of early treatment in clinical practice, the treat to target principle, and new medicines such as biologic disease-modifying antirheumatic drugs, clinical remission can be achieved early in the disease course, albeit not in all patients. The clinical response and efficacy of biologic disease-modifying antirheumatic drugs vary among different individuals. Therefore, there is a need to develop a more personalized approach toward treatment to achieve rapid remission in every patient to prevent disability and restore and maintain quality of life, without unnecessary adverse effects, in a cost-effective manner. The latest data from explorative studies of predictive markers of response are discussed here, together with a preliminary treatment algorithm based on currently available knowledge. (C) 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc.
引用
收藏
页码:1129 / 1143
页数:15
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