"Of course, the circumstances and preferences of individual patients with rheumatoid arthritis are already taken into account as much as possible in clinical practice," explains Daniel Aletaha, Head of the Division of Rheumatology and the Department of Medicine III at MedUni Vienna. However, the treatment of rheumatoid arthritis (RA) has so far lacked the necessary scientific "formalization" to systematically pursue this integrative and comprehensive approach to precision medicine. The conceptual system developed by Daniel Aletaha and co-author Victoria Konzett, also from MedUni Vienna's Department of Medicine III, can close this gap. It includes the consideration of parameters, which can be acquired during a simple medical consultation and can then be evaluated and used to make treatment decisions more precisely.
"Therapeutic matchmaking"
"Today, we have a wide range of medications available for the treatment of rheumatoid arthritis, all of which work well," says Daniel Aletaha. "Yet the key differentiator of drugs does not lie in their efficacy, but rather in their safety profile for individual patients." For example, the best treatment for people with rheumatoid arthritis and concomitant heart failure may be different than the best treatment for RA patients with recurrent herpes zoster. These and other components of an individually optimized treatment are presented in a structured manner in the model. Its application in clinical practice could lead to a process that the authors refer to as "therapeutic matchmaking". In this process, doctors and patients agree on a therapy that is both effective and safe for the specific conditions of individual patients.
"Precision medicine clearly goes beyond choosing the most individually effective drug", Daniel Aletaha clarifies. According to Aletaha, integrating the safety profiles of the therapeutic agents, the multimorbid situation of the patients to be treated and their preferences into the treatment decision can significantly improve treatment outcomes for patients and increase their quality of life.
Publication: Nature Reviews Rheumatology
Management strategies in rheumatoid arthritis
Victoria Konzett, Daniel Aletaha
https://www.nature.com/articles/s41584-024-01169-7