Future pharmacogenomics aspects in rheumatoid arthritis

Author(s): Christiana Williams

Since its early clinical investigations in the 1980s, Methotrexate (MTX), a folate analogue, has been used as the first-line Disease-Modifying Anti-Rheumatic Medicine (DMARD). Although the actual mechanism of action of MTX, which was originally designed as a leukaemia treatment, has been proved to be beneficial in reducing inflammation in RA, the exact mechanism of action is still unknown. Other DMARDs have been developed, including azathioprine, leflunomide, chloroquine, sulfasalazine, and ciclosporin A. Despite the large number of treatments available, they all have significant toxicity and poor efficacy in common. Prior to the year 2000, remission from RA was not thought to be a possibility. The illness progressed to more severe versions in many cases, and the clinical specialist had to empirically determine the efficacy of each DMARD on each patient.