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Pharmacogenetics in treatment of rheumatoid arthritis.

机译：类风湿关节炎的药物遗传学治疗。

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Over the last decades important progress is being made regarding disease modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA). Nevertheless, a substantial part of the patients fail to achieve a good response and/or experience toxicity, which limits further treatment leading to progression of inflammation and destruction of joints. These high interindividual differences in drug response gave rise to the need for prognostic markers in order to individualize and optimize therapy with these antirheumatic agents. Besides demographic and clinical factors, studies in the research field of pharmacogenetics have reported potential markers associated with clinical response on treatment with methotrexate and TNF inhibitors. However, publicized conflicting results and underlying interpretation difficulties inhibit drawing definitive conclusions. Presently, clinical implementation of pharmacogenetics as an important step for individualizing drug therapy in RA is not feasible yet. Replication and prospective validation in large patient cohorts are required before pharmacogenetics can be used in clinical practice. This review provides the current state of art in genotyping RA patients as a potential guide for clinical decision making.
机译：在过去的几十年中，在类风湿关节炎（RA）的治疗中，抗风湿药物（DMARDs）的研究取得了重要进展。然而，很大一部分患者未能获得良好的反应和/或经历毒性，这限制了进一步治疗，导致炎症进展和关节破坏。这些个体间高度的药物反应差异导致需要预后指标，以个性化和优化这些抗风湿药的治疗方法。除了人口统计学和临床​​因素，药物遗传学研究领域的研究还报告了与甲氨蝶呤和TNF抑制剂治疗的临床反应相关的潜在标志物。但是，公开的矛盾结果和潜在的解释困难阻碍了得出明确的结论。目前，将药物遗传学作为在RA中个体化药物治疗的重要步骤的临床实施尚不可行。在药物遗传学可用于临床之前，需要在大型患者队列中进行复制和前瞻性验证。这篇综述提供了RA患者基因分型的最新技术，作为临床决策的潜在指南。

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