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Viewpoint: Could better understanding of risk factors for comorbidities pave the way towards personalized therapy in rheumatoid arthritis?

Journal

RHEUMATOLOGY
Volume 62, Issue SI3, Pages SI271-SI273

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/kead352

Keywords

Comorbidities; personalized medicine; rheumatoid arthritis; risk factors

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In addition to joints, rheumatoid arthritis can affect several organs. Coexisting conditions with different pathomechanisms contribute to disease activity, treatment efficacy, mortality, and quality of life. Personalized treatment, considering established comorbidities and contraindications, can lead to better treatment outcomes. Further research can enable assessment of individual risk for future development of comorbidities, based on biomarkers. This biomarker-based person-centred therapy can improve disease control, survival, and quality of life in rheumatoid arthritis.
In addition to joints, several organs can be affected in rheumatoid arthritis. Coexisting conditions with different pathomechanisms all contribute to disease activity, treatment efficacy, mortality and quality of life. The wide selection of treatment options makes it possible for rheumatologists to personalize treatment for their patients, which in present practice mainly includes the consideration of established comorbidities and contraindications. We suggest that further research can enable clinicians to take into account the individual risk of the future development of comorbidities, when making therapeutic decisions. Individual risk assessment could be mainly based on biomarkers and the better understanding of the patomechanism of different coexisting conditions, as we highlight with the examples of depression and interstitial lung disease. This biomarker-based person-centred therapy can lead not only to the treatment but ideally even the prevention of coexisting conditions, and can lead to better disease control, survival and quality of life in rheumatoid arthritis.

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