The Potential for Personalized Treatment

During the last year, many news stories have come out about the use of precision medicine to treat cancer. This involves testing the genome of the patient (and even their tumor) to determine the best course of treatment by matching the medicine to the precise genome.

New research suggests there is growing potential for using precision medicine for other conditions, such as rheumatoid arthritis. Research teams are working to understand how chronic disease starts and identify any related changes in the genome.

The goal is to understand why some people are more likely to develop certain chronic diseases, like rheumatoid arthritis. Additionally, research may be able to help with predicting what treatments may be most effective on specific patients.

With the research in its early stages, there’s a long way to go and potentially many complicating factors. For example, what if rheumatoid arthritis is a combination of genetic influence and environmental experience? How can we understand the interplay and what would be the effect on approaching treatment? Could we get to a point of prediction and prevention for RA? What would this look like?

Another study found that RA attacks different joints in different ways. The researchers think that this finding indicates treatment may need to be targeted by joint and that some treatments will work better on individual joints than others.

In my case, my RA started in my left knee and it continued to be worse there than most of my other joints. While it eventually attacked my hips pretty aggressively, along with other joints, the left knee was always a hot spot. Sometimes I also think there was a favoring of my RA to attack my left joints, as the hand and shoulder on that side are more damaged than the joints on the right.

Although it is interesting to see my experience supported by research, I can’t envision how current treatments would be able to target one or several joints for greater effectiveness. What is more hopeful for me is to see if genetic testing would help identify treatments that better match my body and illness over others.

Right now the therapeutic experience is largely trial and error. People with RA try a drug for a few months to see if it works, then move on to the next. Additionally, sometimes a drug will seem to work for a while and then lose its effectiveness. I’m experiencing this currently with a biologic treatment. My question is—do I try another or will it not work any better? How is my body’s response to treatment affecting my RA?

Wouldn’t it be great to know in advance what drugs will work best against our RA to save us time, money, damage, and anxiety? It may be wishful thinking, but it would be such a help to better plan a course of treatment with useful genetic information.

I also wonder if treatments will be altered by understanding how an individual’s environment affects their genome? For example, if I lived in a specific climate or area, would my RA be more inclined to stay stable or even enter remission? Are there aspects of changing my environment that would definitely alter my RA?

During the course of my illness, I have tried different diets and lived in different places, but never observed any noticeable change to my RA. Perhaps there is a factor that could be changed for a helpful response.

All of this is to say that I look forward to the emerging era of personalized medicine and the potential impact it could have on more effective treatments for rheumatoid arthritis. Targeting treatment could do a whole lot of good for people struggling with this disease.

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