Will Pharmacogenetics Predict Response to Therapies in Rheumatoid  Arthritis?

Happy      Chan; Prabha      Ranganathan

doi:10.2174/157016006778992750

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that mainly affects the joints. When left un-treated, the disease can be aggressive resulting in irreversible joint damage with high morbidity and mortality. Disease modifying anti-rheumatic drugs (DMARDS) are the cornerstones of treatment in RA. In recent times, a new class of dis-ease-modifying medications, the biologics, has been added to the therapeutic armamentarium in RA. DMARDs not only ameliorate the clinical signs and symptoms of disease, but also prevent the radiographic progression of joint damage. However, there is significant variability in patients response to these agents, both in terms of efficacy and toxicity. At thepresent time, there are no reliable means of predicting, a priori, an individual patients response to a given DMARD. In this review, the current published literature on the pharmacogenetics of traditional DMARDS and the newer biological DMARDs is highlighted. Pharmacogenetics may be a powerful tool for opti mizing drug therapy in patients with rheuma-toid arthritis.

Keywords: Pharmacogenetics, polymorphisms, rheumatoid arthritis, methotrexate, azathioprine, sulfasalazine, tumor necrosis factor antagonists

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