Dr Allan Gibofsky: The Need for Individualized Treatments in RA
There is a need in rheumatoid arthritis to be able to individualize treatments, but without credible and reliable biomarkers, it just isn't possible yet, said Allan Gibofsky, MD, professor of medicine and public health at Weill Cornell Medical College and an attending rheumatologist at Hospital for Special Surgery.
Transcript (slightly modified) What are the current challenges in rheumatoid arthritis treatment?
I think among the more significant challenges are the ability to predict who will do well and who will not. We haven't yet evolved to the stage where we have credible and reliable biomarkers to allow us to individualize therapy—perhaps someday we will. But for now, despite our guidelines and despite our recommendations, we're still acting empirically in the choice of therapies.
What developments would you like to see in rheumatoid arthritis medication?
I would love to see a medication that helps all people, all times, whenever they take it with no toxicity whatsoever. I would also also like to see a balanced budget and world peace. And I'm realistic to realize that just as I probably won't see the latter, we're not going to have a medication that is going to be effective for everyone without any side effects at all.
Consequently, what we really need are medications that can be individualized for a given patient to either enhance efficacy or minimize toxicity from the individual agent.