Inflammatory rheumatic diseases are different pathologic conditions associated with a deregulated immune response, codified along a spectrum of disorders, with autoinflammatory and autoimmune diseases as two-end phenotypes of this continuum. Despite pathogenic differences, inflammatory rheumatic diseases are commonly managed with a limited number of immunosuppressive drugs, sometimes with partial evidence or transferring physicians' knowledge in different patients. In addition, several randomized clinical trials, enrolling these patients, did not meet the primary pre-established outcomes and these findings could be linked to the underlying molecular diversities along the spectrum of inflammatory rheumatic disorders. In fact, the resulting patient heterogeneity may be driven by differences in underlying molecular pathology also resulting in variable responses to immunosuppressive drugs. Thus, the identification of different clinical subsets may possibly overcome the major obstacles that limit the development more effective therapeutic strategies for these patients with inflammatory rheumatic diseases. This clinical heterogeneity could require a diverse therapeutic management to improve patient outcomes and increase the frequency of clinical remission. Therefore, the importance of better patient stratification and characterization is increasingly pointed out according to the precision medicine principles, also suggesting a new approach for disease treatment. In fact, based on a better proposed patient profiling, clinicians could more appropriately balance the therapeutic management. On these bases, we synthetized and discussed the available literature about the patient profiling in regard to therapy in the context of inflammatory rheumatic diseases, mainly focusing on randomized clinical trials. We provided an overview of the importance of a better stratification and characterization of the clinical heterogeneity of patients with inflammatory rheumatic diseases identifying this point as crucial in improving the management of these patients.
Dettaglio pubblicazione
2024, AUTOIMMUNITY REVIEWS, Pages 1-23 (volume: 2024)
Tailoring the treatment of inflammatory rheumatic diseases by a better stratification and characterization of the clinical patient heterogeneity. Findings from a systematic literature review and experts' consensus (01a Articolo in rivista)
Ruscitti Piero, Allanore Yannick, Baldini Chiara, Barilaro Giuseppe, Bocci Elena Bartoloni, Bearzi Pietro, Bellis Elisa, Berardicurti Onorina, Biaggi Alice, Bombardieri Michele, Cantarini Luca, Cantatore Francesco Paolo, Caporali Roberto, Caso Francesco, Cervera Ricard, Ciccia Francesco, Cipriani Paola, Chatzis Loukas, Colafrancesco Serena, Conti Fabrizio, Corberi Erika, Costa Luisa, Currado Damiano, Cutolo Maurizio, D'Angelo Salvatore, Del Galdo Francesco, Di Cola Ilenia, Di Donato Stefano, Distler Oliver, D'Onofrio Bernardo, Doria Andrea, Fautrel Bruno, Fasano Serena, Feist Eugen, Fisher Benjamin A., Gabini Marco, Gandolfo Saviana, Gatto Mariele, Genovali Irene, Gerli Roberto, Grembiale Rosa Daniela, Guggino Giuliana, Hoffmann-Vold Anna Maria, Iagnocco Annamaria, Iaquinta Francesco Salvatore, Liakouli Vasiliki, Manoussakis Menelaos N., Marino Annalisa, Mauro Daniele, Montecucco Carlomaurizio, Mosca Marta, Naty Saverio, Navarini Luca, Occhialini Daniele, Orefice Valeria, Perosa Federico, Perricone Carlo, Pilato Andrea, Pitzalis Costantino, Pontarini Elena, Prete Marcella, Priori Roberta, Rivellese Felice, Sarzi-Puttini Piercarlo, Scarpa Raffaele, Sebastiani Giandomenico, Selmi Carlo, Yehuda Shoenfeld, Triolo Giovanni, Trunfio Francesca, Yan Qingran, Tzioufas Athanasios G., Giacomelli Roberto
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