“High” and “Low” Gene Expression Signatures in Rheumatoid Arthritis: an Emerging Approach for Patient Stratification and Therapy Choice

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease with unknown etiology that affects various pathways within the immune system, involves many other tissues and is associated with joint destruction. Current treatments fail to address pathophysiological and biochemical mechanisms involved in joint degeneration and the induction of pain. Moreover, RA patients are extremely heterogeneous and require specific treatments, the choice of which is complicated by the fact that not all patients respond to treatment. At present, patient assessment involving clinical, immunological, and radiological traits does not permit the prediction of the anti-rheumatic treatment response in approximately half of RA subjects. Recent data suggest that patient stratification, in accordance with the level of pro-inflammatory gene expression, may help to predict response to RA therapy.