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RHEUMATOLOGY

Inching closer to precision treatment for rheumatoid arthritis

Nature Medicine volume 28, pages 1129–1131 (2022)Cite this article

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Biopsies from synovial joints — and the abundance of B cells and macrophages therein — may instruct more effective treatment decisions for individuals with rheumatoid arthritis.

Designing precision medicine treatment strategies for rheumatoid arthritis (RA) is an imperative, yet a humbling challenge. Successful examples of precision treatment have, thus far, largely involved conditions where a single causal genomic variant was identified and a counteracting drug was developed. For RA and most autoimmune conditions, however, precise causal mechanisms remain unclear. Fortunately, more than 20 medications are approved for RA and show efficacy in at least a fraction of patients1,2. While their mechanisms of action amidst the complex pathophysiology of RA are not fully understood, most were ‘rationally’ designed against specific molecules, such as TNF, CD20 and JAK3. Emerging innovative trials may be moving us closer to precision medicine for RA3,4 — albeit in reverse — by using these targeted therapies and identifying the relevant molecular targets in patients who ultimately respond.

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Fig. 1: Cell types in rheumatoid arthritis-affected joints may guide more effective treatment decisions.

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Authors and Affiliations

  1. HSS Research Institute, New York, NY, USA

    Laura T. Donlin

  2. Weill Cornell Medicine, New York, NY, USA

    Laura T. Donlin

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  1. Laura T. Donlin
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Correspondence to Laura T. Donlin.

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Competing interests

L.T.D. is a member of the NIH-industry sponsored Accelerating Medicines Partnership consortium.

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Donlin, L.T. Inching closer to precision treatment for rheumatoid arthritis. Nat Med 28, 1129–1131 (2022). https://doi.org/10.1038/s41591-022-01857-5

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