The promise of precision medicine in rheumatology

Nat Med. 2022 Jul;28(7):1363-1371. doi: 10.1038/s41591-022-01880-6. Epub 2022 Jul 4.


Systemic autoimmune rheumatic diseases (SARDs) exhibit extensive heterogeneity in clinical presentation, disease course, and treatment response. Therefore, precision medicine - whereby treatment is tailored according to the underlying pathogenic mechanisms of an individual patient at a specific time - represents the 'holy grail' in SARD clinical care. Current strategies include treat-to-target therapies and autoantibody testing for patient stratification; however, these are far from optimal. Recent innovations in high-throughput 'omic' technologies are now enabling comprehensive profiling at multiple levels, helping to identify subgroups of patients who may taper off potentially toxic medications or better respond to current molecular targeted therapies. Such advances may help to optimize outcomes and identify new pathways for treatment, but there are many challenges along the path towards clinical translation. In this Review, we discuss recent efforts to dissect cellular and molecular heterogeneity across multiple SARDs and future directions for implementing stratification approaches for SARD treatment in the clinic.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Autoantibodies
  • Autoimmune Diseases*
  • Humans
  • Precision Medicine
  • Rheumatic Diseases* / drug therapy
  • Rheumatic Diseases* / genetics
  • Rheumatology*


  • Autoantibodies