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Pharmacogenomics, the study of the effect of genetics on the variation in drug response, is designed to maximize drug efficacy and minimize adverse effects. It is assuming increasing importance in clinical practice. Rheumatologists, who manage patients with complex diseases with unpredictable outcomes over long periods of time, should embrace tools that help customize treatment for their patients. In this article, the basis for pharmacogenomics is presented, followed by description of the tests relevant to drugs encountered in rheumatology practice, concluding with ideas about implementation and future developments.