Drug resistance in anti-TNF therapy of psoriatic arthritis

Introduction. Despite of the molecular targeting anti-TNF therapy, drug resistance may be observed. A method of avoiding this phenomenon, changing treatment early and increasing its effectiveness, the new molecular markers may be used. Objective. To present clinical (PAST, BSA, DAS28, DLQI) and molecular (TNF-alpha, TNFR1, TNFR2) parameters of loss of efficacy to etanercept in a patient with psoriatic arthritis. Case report. Patient aged 64, initially treated with etanercept then adalimumab because of psoriatic arthritis. During the observation, the loss of response to the anti-TNF drug was observed. During subsequent visits, whole blood was collected from the patient for molecular analysis based on the RTqPCR. Conclusions. Molecular markers such as TNF-alpha, TNFR1, TNFR2 seem to be useful for early detection of drug resistance and fit into the model of personalised medicine.