Personalized medicine for connective tissue disease: Historical and future perspectives

Connective tissue disease (CTD), previously termed collagen disease, is a group of disorders, characterized by rheumatic symptoms, autoimmunity, and degeneration of the pathohistology of the extracellular matrix. Better classification and disease subsetting, as well as introduction of immunosuppressants and molecular-targeting drugs, have much improved patients' quality of life and prognosis. The treat-to-target strategy in combination with emphasis on early diagnosis and intervention is now advocated for many CTDs. However, there remains a need to determine the appropriate management for individual patients, as clinical presentation and treatment response are highly variable among patients. A personalized medicine approach based on comprehensive patient profiles can improve patient care and long-term outcomes by decreasing the number of treatment failures, improving drug safety, and reducing the complications and organ damage associated with the disease and its treatment. Tremendous efforts have been made to identify patients who require early aggressive treatment, but the current knowledge on predicting the treatment response to individual drugs is limited. Better coordination between basic and clinical science is the key to providing a basis for tailored approaches for individual patients with CTD.