The Role of Immuno-Genetic Biomarkers in Assessing the Effectiveness of Antirheumatic Therapy in Late-Stage Rheumatoid Arthritis
Keywords:
Rheumatoid arthritis; late-stage disease; immuno-genetic biomarkers; DMARDs; cytokines; pharmacogenetics; treatment responseAbstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent synovial inflammation, progressive joint destruction, and significant functional disability. In late-stage RA, therapeutic response becomes highly heterogeneous due to accumulated structural damage, immune exhaustion, and genetic variability influencing treatment sensitivity. Despite the availability of conventional synthetic, biological, and targeted synthetic disease-modifying antirheumatic drugs (DMARDs), a substantial proportion of patients fail to achieve sustained remission or low disease activity in advanced disease stages. In this context, immuno-genetic biomarkers have emerged as critical tools for predicting therapeutic response, monitoring treatment efficacy, and guiding personalized therapeutic strategies. This review summarizes current evidence on the role of immunological markers (including cytokines, autoantibodies, and immune cell profiles) and genetic polymorphisms (notably within HLA, cytokine, and immune regulatory genes) in evaluating antirheumatic therapy effectiveness in late-stage RA. Understanding the immuno-genetic landscape of advanced RA has important implications for precision medicine, optimized treatment selection, and improved long-term outcomes.
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