The Role of Pharmacogenomics in Personalizing Pharmacotherapy for Autoimmune –Associated Interstitial Lung Disease [Ild]

Pharmacogenomics (PGx) is an important component of precision medicine that explores how genetic differences between individuals can influence their response to drug therapy. Autoimmune-associated interstitial lung disease (AI-ILD) represents a diverse group of conditions characterized by variations in disease progression, treatment effectiveness, and susceptibility to adverse drug reactions. These differences can make conventional approaches to immunosuppressive and antifibrotic therapy less predictable. This review examines the potential application of pharmacogenomics in developing individualized treatment strategies for patients with AI-ILD. Particular emphasis is placed on genetic variations that may influence drug metabolism, transport, molecular targets, therapeutic response, and treatment-related toxicity. The pharmacogenomic relevance of commonly used therapies, including mycophenolate mofetil, azathioprine, cyclophosphamide, methotrexate, glucocorticoids, biologic therapies, and antifibrotic agents, is discussed. Established biomarkers, particularly TPMT and NUDT15 in thiopurine treatment, are highlighted alongside emerging genetic findings for other therapies. Despite its potential, clinical application remains limited by the scarcity of ILD-specific evidence, small study populations, variable genetic associations, and insufficient prospective validation. Combining pharmacogenomic data with clinical, radiological, and molecular information may facilitate more individualized therapeutic decision-making. Further research is necessary to establish clinically validated pharmacogenomic strategies for routine use in AI-ILD.