Pharmacogenomics in multiple sclerosis: getting the right medicine to the right patient

Manuel Comabella

Disease-modifying therapies in multiple sclerosis have demonstrated a beneficial effect on disease activity. Furthermore, an increasing number of new therapeutic strategies with a diverse set of actions are becoming available. However, not all patients respond to current disease-modifying therapies, and a substantial interindividual variability exists in both efficacy and toxicity. This inevitable and unprecedented resource of new therapies and the potential risk for treatment failure emphasizes the necessity of personalized therapy for patients with multiple sclerosis. Currently, there is a lack of markers that reliably correlate with responsiveness to disease-modifying therapies in multiple sclerosis. Pharmacogenomics holds great promise for individualized therapy and is a reality in several types of malignancies, in which markers influencing efficacy and toxicity of therapy are identified and used to make therapeutic decisions. Nevertheless, pharmacogenomics of multiple sclerosis is still in its infancy, and big efforts should first be made in order to identify markers for treatment efficacy that may help tailor drug therapy in patients with multiple sclerosis.