Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, the Second Military Medical University, Shanghai, 200003, China.
School of Economics and Management, Tongji University, Shanghai, 200092, China.
Front Med. 2019 Aug;13(4):411-419. doi: 10.1007/s11684-018-0659-3. Epub 2019 Jan 12.
Although many drugs and therapeutic strategies have been developed for rheumatoid arthritis (RA) treatment, numerous patients with RA fail to respond to currently available agents. In this review, we provide an overview of the complexity of this autoimmune disease by showing the rapidly increasing number of genes associated with RA.We then systematically review various factors that have a predictive value (predictors) for the response to different drugs in RA treatment, especially recent advances. These predictors include but are certainly not limited to genetic variations, clinical factors, and demographic factors. However, no clinical application is currently available. This review also describes the challenges in treating patients with RA and the need for personalized medicine. At the end of this review, we discuss possible strategies to enhance the prediction of drug responsiveness in patients with RA.
虽然已经开发出许多用于治疗类风湿关节炎 (RA) 的药物和治疗策略，但仍有许多 RA 患者对现有药物无反应。在这篇综述中，我们通过展示与 RA 相关的基因数量不断增加，提供了对这种自身免疫性疾病复杂性的概述。然后，我们系统地回顾了各种具有预测价值（预测因子）的因素，这些因素对 RA 治疗中不同药物的反应有影响，尤其是最近的进展。这些预测因子包括但不限于遗传变异、临床因素和人口统计学因素。然而，目前尚无临床应用。本综述还描述了治疗 RA 患者所面临的挑战以及对个性化医疗的需求。在这篇综述的最后，我们讨论了增强 RA 患者药物反应预测的可能策略。
