These pathologies are over two hundred, affect more than five million Italians (including many young people and under 50) and some of them can be associated with serious forms of disability
On June 3, the European Congress of Rheumatology (Eular) ended in Milan, where approx 15 thousand rheumatologists from all over the world they discussed the latest news on rheumatological pathologies. The decision to hold the congress in Milan bears witness to the leading role of our country in research in this sector and the high level of Italian rheumatologists. There are over 200 rheumatological diseases, they affect more than 5 million Italians and some of them can be associated with serious forms of disability (they are the leading cause of disability in Europe). They include serious systemic autoimmune diseases, which can affect all organs of the human body, such as systemic lupus erythematosus, systemic sclerosis, vasculitis; inflammatory joint diseases with possible involvement of other organs, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis; non-inflammatory or mildly inflammatory joint diseases, such as osteoarthritis, osteoporosis, fibromyalgia.
A significant proportion of rheumatological patients are in the age group of 30 – 50 years oldwith peaks in the incidence of some diseases in the range of 20 – 40 years oldoften prevalent in women of childbearing ageand there are cases with onset in childhood. Early diagnosis and timely initiation of appropriate drug therapy can improve the prognosis and avoid complications affecting the osteoarticular system and other organs and systems. However, the diagnosis and management of these diseases are hampered by their complexity and by the lack of rheumatological assistance in public facilities: the general practitioner very often has no way of referring the patient to the rheumatologist, who is therefore seen by other specialists; in some hospitals we attend the failure to renew the Heads of Rheumatology or to the downgrading of rheumatological facilities.
The consequences are the diagnostic delay, the progression of the irreversible damage, huge inconveniences and individual expenseswaste of social resources linked to inappropriate diagnostic and therapeutic pathways, increase in expenditure for disability. A number of drugs are currently available, including biologics“targeted” immunosuppressants with an excellent efficacy and safety profile, which have made it possible to avoid the use of cortisone, improve the quality of life, reduce the accumulation of damage, mortality and social expenditure linked to disability. The adherence to therapy is fundamental: discontinuing the drugs can lead to the resumption of symptoms and the accumulation of irreversible damage. Furthermore, even if the therapy is restarted, in some cases it is no longer possible to achieve the same levels of efficacy obtained before the suspension.
* Director of Rheumatology San Camillo – Forlanini, Rome; National President of the Italian Society of Rheumatology
June 4, 2023 (change June 4, 2023 | 14:08)
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