Pharmacogenetic Testing for Arthritis Medications

Arthritis Overview

Arthritis broadly refers to joint inflammation, without distinguishing cause. Arthritis is often, but not always, associated with joint pain and stiffness though specifics, as well as other symptoms, tend to vary by arthritis type. Specific types of arthritis include osteoarthritis, rheumatoid arthritis and gouty arthritis. 

Diagnosis is done by appropriate health care providers. Considerations may include symptoms, imaging results and blood work. Though genetic factors do play a role in multiple arthritis types, arthritis genetic testing (e.g., for rheumatoid) is generally not part of usual diagnosis. 

Osteoarthritis development is linked to a few factors, including joint injury and wear-and-tear, older age, female sex and obesity. It can affect single or multiple joints, including knee and hip joints.

Rheumatoid arthritis is an auto-immune condition - this means that the body's immune system reacts to its own body. The causes are complex and not fully understood. Painful swelling of smaller joints, like those in the hands and feet are common, and often affect both left and right sides. Symptoms in other parts of the body, like fatigue and weight loss, can also be present.

Gouty arthritis is a condition that usually results from a higher-than-normal concentration of a normal bodily waste product in the blood that deposits and forms crystals in one or more joints. Joints in the foot and lower half of the leg are common. Strong and rapid appearance of pain and reduced functioning tend to appear, along with noticeable inflammation in the affected joint(s). (1)

Common Arthritis Medications

Medication approaches used in various arthritis types partially overlap in some cases but do have distinctions.

Non-steroidal anti-inflammatory drugs (NSAIDs) like celecoxib and meloxicam are typically used to help manage pain and related effects (like overall functioning) across many arthritis types. Though their full effect is sometimes not experienced until 2 weeks of regular use have passed, certain side effect risks tend to become more prominent with regular use. These include increases in blood pressure, and reductions in kidney functioning, particularly in those with other risk factors. 

Allopurinol is a key treatment used in those with gout to help prevent gouty arthritis. However, a small number of individuals can be predisposed to serious hypersensitivity side effects that can cause skin to detach and may even affect other organs and cause death. 

Azathioprine is used to help control the immune system in some cases of rheumatoid arthritis. It can also be used to help prevent other types of rheumatoid arthritis medications from becoming ineffective other time. However, some individuals' immune system may be suppressed to a great degree than necessary and increase the risk that they might not be able to fight infections normally. 

How Pharmacogenetic Testing Can Help with Arthritis Treatment

Genetic factors can be involved in how individuals could respond (including arthritis medication side effects). Specific testing can help identify those with poor potential response to some of the medications used for arthritis, including those discussed previously. This is known as arthritis pharmacogenetic testing. It should be noted that this is distinct from other forms of genetic testing, like testing for rheumatoid arthritis genetic markers.

Is Pharmacogenetic Testing Right for Your Arthritis Treatment?

Pharmacogenetic testing analyzes individuals' DNA for variations known to impact side effects and/or effectiveness associated with a number of medications. This information can then be used to inform the choice of the medication selected, or the dose, monitoring, or further investigations needed when prescribers select a certain medication to improve treatment response. For those with a new arthritis diagnosis wanted to reduce the likelihood of medication related issues from the start, or for those with an established diagnosis with unmet medication needs, pharmacogenetic testing can be a key tool for them and their health care provider to use to help inform medication decisions.

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