Predicting response to TNF antagonists in rheumatoid arthritis: The promise of pharmacogenetics research using clinical registries

Despite the demonstrated efficacy of three different classes of biologic response modifiers (BRMs) for the treatment of rheumatoid arthritis (RA), there are currently no clinical predictors or biomarkers that can rationally guide physicians in the selection of BRMs for individual patients. One promising area of translational research for patients with RA is the field of pharmacogenetics. In the absence of industry-sponsored pharmacogenetic studies of BRMs, longitudinal clinical registries may represent the most promising setting for identifying genetic biomarkers. This review focuses on published pharmacogenetic studies of TNF antagonists and discusses related methodologic issues for pharmacogenetic research using clinical registries.