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Precision Medicine, It Is Time to Tailor and Drive the...
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Precision Medicine, It Is Time to Tailor and Drive the Treatment in Rheumatic Diseases

A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (15 June 2022) | Viewed by 6406

Special Issue Editors

Dr. Silvia Bellando Randone

E-Mail Website
Guest Editor
Department of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of Florence, 50141 Florence, Italy
Interests: rheumatic diseases; early diagnosis; microbiota; biomarkers
Special Issues, Collections and Topics in MDPI journals
Dr. Gemma Lepri

E-Mail Website
Guest Editor
AOU Careggi, University of Florence, Division of Rheumatology, Florence, Italy
Interests: systemic sclerosis; autoimmune diseases; heumatic diseases
Dr. Edda Russo

E-Mail Website
Guest Editor
Department of Experimental and Clinical Internal Medicine, University of Florence, Florence, Italy
Interests: the microbiome–immunity axis; microbial metabolites; inflammatory bowel diseases; colorectal cancer; immunonutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The term “precision medicine” has become increasingly popular by proposing a medical model which allows to choose a personalized treatment, tailoring therapeutic strategies to the individual characteristics of each patient. In fact, precision medicine has been defined as a new approach for disease treatment and prevention that considers individual variability in genes, lifestyle and environmental exposure.

In rheumatic diseases, often characterized by wide phenotypic heterogeneity, precision medicine is still an emerging area. Recently, significant efforts have been made to better understand the pathogenetic mechanisms in several rheumatic diseases. Advances in biological molecular-targeted therapies have brought remarkable progress in their treatment.

The combination of clinical, laboratoristic, instrumental features and molecular and genetic pathways should allow to identify patients with similar disease courses and treatment responses. Therefore, through knowledge of these features, a precision medicine approach may guide the choice of treatment and the timing of its administration in order to maximize drug efficacy, determining the optimal treatment regimen for each patient.

Dr. Silvia Bellando-Randone
Dr. Gemma Lepri
Dr. Edda Russo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • precision medicine
  • therapeutic approach
  • prognosis
  • clinical heterogeneity
  • patients stratification
  • personalized therapeutic approach
  • rheumatic diseases
  • autoimmune disease

Published Papers (2 papers)

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11 pages, 719 KiB  
Systematic Review
Comparison of Adalimumab to Other Targeted Therapies in Rheumatoid Arthritis: Results from Systematic Literature Review and Meta-Analysis
by Fabio Cacciapaglia, Vincenzo Venerito, Stefano Stano, Marco Fornaro, Giuseppe Lopalco and Florenzo Iannone
J. Pers. Med. 2022, 12(3), 353; https://doi.org/10.3390/jpm12030353 - 25 Feb 2022
Cited by 9 | Viewed by 3691
Abstract
Few studies compared adalimumab to other targeted therapies in head-to-head randomized clinical trials (RCTs) for rheumatoid arthritis (RA), but multiple comparisons are not available. This Bayesian Network Meta-Analysis evaluated which targeted therapy is more likely to achieve ACR50 response with good safety at [...] Read more.
Few studies compared adalimumab to other targeted therapies in head-to-head randomized clinical trials (RCTs) for rheumatoid arthritis (RA), but multiple comparisons are not available. This Bayesian Network Meta-Analysis evaluated which targeted therapy is more likely to achieve ACR50 response with good safety at 24 weeks of treatment in RA. A systematic literature review was conducted for head-to-head phase 3 RCTs that compared adalimumab to other targeted therapies in combination with methotrexate (MTX) or as monotherapy to treat RA patients, and searched through MEDLINE, EMBASE, Cochrane Library and Clinicaltrial.gov. The outcomes of interest were ACR50 response and withdrawals due to adverse events at 24 weeks. WinBUGS 1.4 software (MRC Biostatistics Unit, Cambridge, UK) was used to perform the analyses, using a random effect model. Sixteen studies were included in the analysis. The most favorable SUCRA for the ACR50 response rate at 24 weeks of treatment in combination with MTX was ranked by upadacitinib, followed by baricitinib, tofacitinib and filgotinib. As monotherapy, the highest probability was ranked by tocilizumab followed by sarilumab. No significant differences in safety profile among treatment options were found. Jak-inhibitors in combination with MTX and interleukin-6 antagonism as monotherapy showed the highest probability to achieve ACR50 response after 24 weeks of treatment. None of assessed targeted therapies were associated to risk of withdrawal due to adverse events. Key messages: Direct and indirect comparison between adalimumab and other targeted therapies demonstrated some differences in terms of efficacy that may help to drive RA treatment. Jak-inhibitors and interleukine-6 antagonists ranked as first in the probability to achieve ACR50 response after 24 weeks of treatment in combination with methotrexate or monotherapy, respectively. Full article
(This article belongs to the Special Issue Precision Medicine, It Is Time to Tailor and Drive the Treatment in Rheumatic Diseases)
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8 pages, 253 KiB  
Perspective
The Role of Tumor Necrosis Factor Alpha Antagonists (Anti TNF-α) in Personalized Treatment of Patients with Isolated Polymyalgia Rheumatica (PMR): Past and Possible Future Scenarios
by Ciro Manzo, Elvis Hysa, Alberto Castagna and Marco Isetta
J. Pers. Med. 2022, 12(3), 329; https://doi.org/10.3390/jpm12030329 - 22 Feb 2022
Cited by 3 | Viewed by 1895
Abstract
Background: Glucocorticoids (GCs) are the cornerstone of polymyalgia rheumatica (PMR) therapy, but their long-term use (as is usually necessary in PMR patients) can induce many adverse events. Alternatives have long been sought. The primary aim of our narrative review is to provide an [...] Read more.
Background: Glucocorticoids (GCs) are the cornerstone of polymyalgia rheumatica (PMR) therapy, but their long-term use (as is usually necessary in PMR patients) can induce many adverse events. Alternatives have long been sought. The primary aim of our narrative review is to provide an overview about the use of anti-tumor necrosis factor alpha (TNF-α) drugs in patients with PMR, and discuss advantages and disadvantages. Materials and methods: we performed a non-systematic literature search (PRISMA protocol not followed) on PubMed and Medline (OVID interface). Results and Conclusions: only two anti TNF-α drugs have been prescribed to PMR patients: infliximab in 62 patients and etanercept in 28 patients. These drugs were normally used in addition to GCs when significant comorbidities and/or relapsing PMR were present; less commonly, they were used as first-line therapy. In general, they have been scarcely successful in patients with PMR. Indeed, randomized controlled trials did not confirm the positive results reported in case reports and/or case series. However, an administration schedule and study design different from those proposed in the past could favour new scenarios in the interest of PMR patients. Full article
(This article belongs to the Special Issue Precision Medicine, It Is Time to Tailor and Drive the Treatment in Rheumatic Diseases)
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