Molecular determinants of treatment response and patient stratification in rheumatoid arthritis

Rheumatoid arthritis (RA) remains one of the most clinically heterogeneous autoimmune conditions, with treatment outcomes varying dramatically across patient populations—even among those receiving identical therapeutic regimens. Emerging evidence highlights molecular and genetic determinants underlying this variability: differences in drug metabolism, immune pathway activation, epigenetic regulation, and gene–environment interactions that define distinct patient endotypes. Despite advanced therapeutic options, including biologic and targeted synthetic DMARDs, treatment failure, primary non-response, and relapse remain common, particularly among patients with certain genetic backgrounds or comorbid systemic manifestations such as RA-associated interstitial lung disease (RA-ILD). Understanding the pharmacogenomic and molecular basis of therapeutic response in RA—and linking these signatures to meaningful patient stratification—is essential to advance precision rheumatology and optimize long-term disease outcomes.This Research Topic focuses on the molecular and genetic determinants of DMARD response, extraarticular manifestations, and patient stratification in RA. We welcome submissions spanning basic, translational, and clinical research, including but not limited to:• Pharmacogenomics of DMARD Response: Genetic and genomic predictors of response or non-response to conventional, biologic, and targeted synthetic DMARDs.• Population Genomics and Genetic Risk Variants: Studies exploring ancestry-specific risk variants and genetic architecture influencing RA susceptibility and progression.• RA-Associated Interstitial Lung Disease (RA-ILD): Molecular pathways, genetic risk factors, and biomarkers underlying pulmonary manifestations and therapy responses.• Molecular Epidemiology and Gene–Environment Interactions: Research integrating environmental exposures, lifestyle, and host genetics to explain disease heterogeneity and treatment outcomes.• Precision Biomarkers for Patient Stratification: Multi-omic discovery and clinical validation of biomarkers supporting individualized therapeutic decisions.• Translational Genomics and Drug Target Discovery: Leveraging genetic and functional genomic evidence (GWAS, Mendelian randomization, CRISPR, systems biology) to identify novel therapeutic targets in RA. Topic editors: RYAN DOS COSTA, Renan Souza, Mauricio Rojas-Lopez Source: https://www.frontiersin.org/research-topics/83479/molecular-determinants-of-treatment-response-and-patient-stratification-in-rheumatoid-arthritis