Potential role of pharmacogenetics for optimalization of drug therapy in rheumatoid arthritis

Kooloos, W.M. (2009)

Doctoral Thesis

Results from this thesis have elucidated potential genetic markers, which were associated with treatment outcome to MTX and adalimumab. Furthermore, a model for predicting the efficacy of MTX in patients with RA was validated in two cohorts indicating that predicting efficacy by a pharmacogenetic model is feasible in RA patients treated with MTX. Importantly, definitive conclusions about the role of genetic predictive factors in treatment outcome to DMARDS could not be drawn, since these results have to be further validated and replicated in future pharmacogenetic studies. Large randomized prospective studies should be planned to demonstrate its legitimate predictive and cost-effective value before a genetically individualized approach is applicable in daily clinical practice. The potential role of pharmacogenetics in the prediction of efficacy and adverse events in RA patients treated with DMARDs is presented in this thesis. Hereby, new knowledge is added to the relatively young research field of pharmacogenetics, which may hopefully lead to a better treatment strategy for RA patients

• Adalimumab
• Functionality
• Methotrexate
• Pharmacogenetics
• Pharmacogenomics
• Replication
• Rheumatoid arthritis
• Single nucleotide polymorphisms
• TNF inhibitor

• All authors: Kooloos, W.M.
• Supervisor: Guchelaar, H.-J.; Huizinga, T.W.J.
• Co-supervisor: Wessels, J.A.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2009-12-09
• ISBN (print): 9789090248349