Environmental exposures and biomarkers predictive of rheumatoid arthritis and the pathway to precision medicine

Rheumatoid arthritis (RA) is regarded as a systemic autoimmune rheumatic disease (SARD) where the major clinical manifestations involve symmetrical arthrodial joints and are associated with increased direct and indirect health care costs (1). Few of the other SARD (i.e., systemic lupus erythematosus (SLE), systemic sclerosis, autoimmune inflammatory myopathies) have been the benefactors of the tremendous progress in understanding RA disease onset, pathogenesis, diagnostic approaches, and therapeutic options (1,2).