More hope for rheumatoid arthritis through early diagnosis and personalized treatment

Talk about rheumatoid arthritis For many, this means thinking about illnesses that are common among older people. A big mistake, since this is a chronic rheumatic pathology of an autoimmune nature, characterized by inflammation of the joints. This can affect anyone. And at any age. In fact, “the average onset of the disease usually occurs around 45 years oldalthough we also see patients significantly lower, as with juvenile rheumatoid arthritis, or significantly higher, with the so-called rheumatoid arthritis of the elderly. However, the majority of victims are young people of working age, fully active and with a family to care for,” warns Dr. Marcos PaulinoPresident of the Spanish Society of Rheumatology (SER).

For example, a button. Lali Alkaidcurrent director of the National Coordinator for Arthritis (ConArtritis), has lived with rheumatoid arthritis for more than three decades. He was diagnosed when he was barely 21 years old.after a long pilgrimage from consultation to consultation until she received the answer to her constant pain, joint stiffness and feeling of fatigue, which she had learned to live with. “Getting a diagnosis is a relief, especially when you are told it is a known disease and has many advances. During these 30 years, I have witnessed a great revolution that gives me great hope.because it is difficult to cope with uncertainty, in addition to the fact that we can learn that it is a chronic illness with its ups and downs.

Your case is not exceptional. Quite the opposite. Figures show that the disease is becoming increasingly common, as it is estimated that approximately In Spain, 300,000 people suffer from rheumatoid arthritisaccording to the SER Episer study. And the situation is getting worse, with about 20,000 new cases diagnosed every year. “The trend we see in the sequence of recent years is the trend slight increaseperhaps because there is more and more information about it and more attention being paid to this disease, leading to more consultations, as well as better training of primary care professionals who are increasingly better prepared to identify the problem and refer it to specialist. . as soon as possible,” says Dr. Paulino.

This early attention is important. “Sometimes Seeing a doctor takes time because you are always trying to find an excuse for these pains or fatigue.but it is very important not to miss it. To achieve a good prognosis, it is important to consult a specialist as soon as possible,” advises Alkaid. And this is confirmed by Dr. Paulino, who assures that “Early diagnosis significantly improves the course of the disease. If it occurs late and without proper control, the inflammation that causes rheumatoid arthritis destroys joints and leads to enormous functional limitations.

Therapeutic window

In particular, as the President of SER clarifies, “it has been shown that there is a therapeutic window for onset of the disease. This is the initial period during which, if vigorous treatment is chosen, lWe hope that the pathology is more benign and therefore the likelihood of the risk of consequences or complications in the medium and long term is significantly reduced.. In fact, this type of patient even has a high chance of ending up in remissionwhich means stupefaction of the disease. All this fully affects patient’s quality of lifetherefore this early approach changes the panorama significantly.

In addition to this promising therapeutic window, acting before the disease shows its face also offers great benefits: “Recent studies show that The use of certain molecules in the pre-arthritic phase can stop the development of this pathology.. This is under investigation, but it certainly confirms that the sooner you take action, the better results you will get,” insists the GER president.

Reducing the risk of possible complications and reducing symptoms is a non-trivial task, especially when it comes to patients diagnosed at an early age. “These are people who, if not treated correctly, live in pictures pain, inflammation, poor quality of night sleep, fatigue, severe fatigue… All this makes them accept sick leave and limit the pace of their social life, which has a strong psychological impact“, says Dr. Paulino. And this is recognized by Alkaid, who admits that “there are patients who leave their profession. A third of patients with rheumatoid arthritis stop working within two years of the onset of the disease. That’s why we require patients to be more flexible at work. Misunderstanding from others is difficult to deal with because you may feel very good and then suddenly have flare-ups of pain and stiffness. For this reason, it is also very important to have psychological support, although unfortunately in public health this is usually not taken into account and this task remains in the hands of patient associations, where you feel understood and where patients also inform and support members family and environment.

Outbreak control

One of the typical characteristics of rheumatoid arthritis is the occurrence of flare-ups. “Because it is an autoimmune disease, When the immune system changes due to genetic, hormonal, or even emotional factors, flare-ups can occur, causing pain and inflammation.. In the most aggressive cases, these episodes cause cumulative damage to the joints and bones, gradually worsening their condition,” explains Dr. Paulino, who clarifies that although all patients may experience them at some point, “They are common in seven out of ten people affected, as it is estimated that 10-15% are able to achieve remission, while a further 10-15% of patients are refractory and do not improve with the treatment offered.which forces us to continue testing new formulas. Fortunately, the current therapeutic arsenal is so broad that a variety of alternatives can be tried, and the good news is that modern treatments allow most patients to have a good quality of life with meaningful work, social and family activities.

And rheumatic diseases cause inflammation in the joints. But not only that. In fact, rheumatoid arthritis is multisystem pathology, which, if left untreated, can become very aggressive for the entire body. “If inflammation is not controlled, it affects other internal organs such as the heart, lungs or kidneys. This can lead to serious health problems such as pericarditis, peripheral nerve damage, vasculitis or eye inflammation, etc.,” warns Dr. Paulino. Fortunately “This risk is significantly reduced when inflammation is controlled with effective treatment, so maintenance and close monitoring are essential to avoid these inconveniences.”“, he adds.

In this scenario, one of the great revolutions that has changed the approach to arthritis treatment in recent years is the commitment personalized medicine. “This means that each patient is studied based on biomarkers that predict the impact and response to a particular treatment. This helps us decide how to proceed and what type of treatment to use in accordance with current protocols and recommendations. The end goal is always strive for the best quality of life for patients because it is possible to live well with arthritis,” confirms Dr. Paulino.

To achieve such good results, it is extremely important to follow adherence to treatment regimen and active monitoring by specialists. “Some people begin to feel well and make the mistake of refusing treatment or not attending periodic checkups, compromising effectiveness,” warns Alkaid. That’s why doctors, patients and researchers are working together to fight arthritis. And they are on the right track.

Unsolved problems

Over the past decade, numerous advances have been made in improving the prognosis of patients with rheumatoid arthritis. World Day is celebrated here every year on October 12th.. However, much remains to be done. At the health level, the director of the National Coordinator for Arthritis (ConArtritis), Lali Alkaid, does not take into account “helps to live with the disease, because sometimes we have to resort to psychologists, physiotherapists, rehabilitation specialists or occupational therapists privately, in addition to difficulties at work,” he laments. For his part, from a medical point of view, Dr. Marcos Paulino pays special attention to “We need to improve access to medicines and new treatments for all patients, no matter where they live.; without forgetting that there is an urgent need to better reallocate human capital, as there is an alarming shortage of specialists in the coming years,” warns Dr. Paulino.