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Forget personalised medicine and focus on abating disease activity
  1. Josef S Smolen1,2,
  2. Daniel Aletaha1
  1. 1Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
  2. 22nd Department of Medicine, Center for Rheumatic Diseases, Hietzing Hospital, Vienna, Austria
  1. Correspondence to Professor Josef S Smolen, 2nd Department of Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; josef.smolen{at}; josef.smolen{at}


In this viewpoint, we summarise three different lines of evidence suggesting that current biological therapies directed at different molecules or cells have similar efficacy in rheumatoid arthritis and target similar populations of patients; therefore, distinct biological effects of targeted therapies may not account for differences in response. Moreover, currently available individual biomarkers or multiple biomarker sets do not provide information beyond that conveyed by clinical disease activity. Smart and novel research designs will have to be developed to find pertinent biomarkers. Until then, the focus of clinicians may have to solely rest on clinical disease activity assessment and targeting remission or low disease activity rapidly.

  • Rheumatoid Arthritis
  • Cytokines
  • DMARDs (biologic)
  • Outcomes research
  • TNF-alpha

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