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

Rheumatoid arthritis (RA) is a chronic inflammatory disease with an unknown aetiology that affects multiple immune system pathways, affects many other tissues, and is associated with joint destruction. Current treatments do not address the pathophysiological and biochemical mechanisms that contribute to joint degeneration and pain induction. Furthermore, RA patients are extremely heterogeneous and necessitate specialised treatments, the selection of which is complicated by the fact that not all patients respond to treatment. Currently, patient assessment involving clinical, immunological, and radiological characteristics does not allow for the prediction of anti-rheumatic treatment response in approximately half of RA patients. Recent evidence suggests that stratifying patients based on the level of pro-inflammatory gene expression may aid in predicting response to RA therapy.