There is an emerging understanding that an individual's risk for future rheumatoid arthritis (RA) can be determined using a combination of factors while they are still in a state where clinically-apparent inflammatory arthritis (IA) is not yet present. Indeed, this concept has underpinned several completed and ongoing prevention trials in RA. Importantly, risk factors can be divided into modifiable (e.g. smoking, exercise, dental care and diet) and non-modifiable factors (e.g. genetics, sex, age). In addition, there are now several biomarkers including autoantibodies, inflammatory markers and imaging techniques that are highly predictive of future clinically-apparent IA/RA. Although none of the prevention studies have yet provided major breakthroughs, several of them have provided valuable insights that can help to improve the design of future clinical trials and enable RA prevention. In aggregate, these findings suggest that the most accurate disease prediction models will require the combination of demographic and clinical information, biomarkers and potentially medical imaging data to identify individuals for intervention. This review summarizes some of the key aspects around precision medicine in RA with special focus on disease prediction and prevention.

中文翻译：

---

类风湿关节炎的精密医学：专注于预测和预防未来的临床疾病。

有一种新的认识是，当人们仍处于尚未出现临床上明显的炎症性关节炎（IA）的状态时，可以使用多种因素来确定其将来患类风湿性关节炎（RA）的风险。确实，这一概念为RA中已完成和正在进行的预防试验提供了基础。重要的是，危险因素可以分为可改变的因素（例如吸烟，运动，牙科保健和饮食）和不可改变的因素（例如遗传，性别，年龄）。另外，现在有几种生物标记物，包括自身抗体，炎症标记物和成像技术，可以高度预测未来的临床表观性IA / RA。尽管没有一项预防研究取得重大突破，他们中的一些人提供了宝贵的见解，可以帮助改善未来临床试验的设计并预防RA。总的来说，这些发现表明，最准确的疾病预测模型将需要结合人口统计和临床信息，生物标记以及可能的医学影像数据来识别需要干预的个体。这篇综述总结了RA中精密医学的一些关键方面，特别侧重于疾病的预测和预防。