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CRÊME PHILADELPHIA, June 10, 2019 / PRNewswire / – Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes significant health problems and high treatment costs. In this issue of Clinical Therapeutics, published by Elsevier, experts are examining many aspects of the detection and intervention of RA, with the general objective of bringing the field closer to the development of effective preventive measures. Identifying people before they develop the disorder could dramatically alter the course of the disease and spare the population its ill effects.
RA affects about 1% of the world's population. It causes swollen and painful joints and can also damage other systems such as skin, eyes, lungs, heart and blood vessels. This debilitating disease results in decreased quality of life, loss of work, pain and suffering. It's also largely an "everlasting" disease whose full-blown RA patients will suffer until the end of their days. Although drugs can control RA in many patients, very few of them experience complete healing and are able to stop treatment. RA is an expensive disease. In United States it currently costs about $ 20,000-30,000 per patient per year for treatment.
Guest edited by Kevin D. Deane, MD, PhD, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine University of Colorado Denver Medicine School, Denver, CO, UNITED STATES; and Tsang Tommy Cheung, MBBS (HK), Clinical Assistant Professor, Department of Medicine, LKS, The Faculty of Medicine University of Hong Kong, Hong KongThis thematic issue draws on the expertise of many scientists around the world and addresses multiple aspects of RA prevention.
"These discussions will hopefully lead to a better understanding of how we can advance RA to the point of preventing the disease and also to indicate how to prevent other autoimmune diseases," explain the guest editors.
Many studies are already underway to learn how to prevent RA. However, the prevention of autoimmune diseases is still a new territory and there is much to discuss and learn. "Most people are well aware of the prevention of diseases such as diabetes, heart disease or cancer," says Dr. Deane. "For example, it is very common for a person to undergo routine blood tests, which could reveal high cholesterol, a potential risk factor for a future heart attack.
"This person can then implement lifestyle changes such as a healthier diet, quitting smoking and more exercise, or taking a medication to reduce the risk of getting sick." 39; a future heart attack.We have developed these approaches for the prevention of heart attack through clinical trials, have learned from these approaches and similar type-preventive trials are underway in PR. "
Dr. Cheung adds that "most autoimmune diseases are only identified when an individual is" sick. "For example, with RA, once someone has painful and swollen joints.
"Blood tests can now identify people at risk before they feel sick, opening up a whole new world of screening and prevention." Treating RA very early may allow cheaper and safer treatments to work because a PR in its own right, usually very powerful drugs are needed to control the disease. "
In a comment on the clinical burden of RA, John M. Davis, III, MD, MS, Associate Professor of Medicine, Division of Rheumatology, Faculty of Medicine and Science, Mayo Clinic, Rochester, MN, USA, states that preventive approaches would greatly benefit patients with RA. "There has been great progress in the development of synthetic, biologic, and targeted disease modifying (DMARD) antirheumatic drugs (DMARDs) to treat RA, as well as strategies for using these agents to control the disease." inflammation badociated with the disease at a low activity level of the disease or clinical remission, "he says. "However, with a given treatment strategy, up to 40-60% of patients ultimately respond inadequately.Investment in the development of preventive strategies should ultimately lead to a paradigm shift in the treatment of disease and its complications in maintaining the health of people around the world. "
Articles in this thematic issue subject to rigorous peer review deal with topics such as the natural history of RA; nomenclature for the stages of development of RA; potential pharmacological targets; prevention potential by targeting mucosal processes; predict RA in people at risk; optimal trial design for RA prevention studies; the patient's preferences; regulatory considerations; the challenges of the system; security monitoring; and adverse events. All authors contributed significantly to the overall development of RA prevention.
The question identifies several important challenges:
- Ensure that the company invests in prevention, which requires that groups such as governments, the insurance industry and pharmaceutical companies also be interested in prevention and be willing to support it.
- Find effective prevention methods, whether drugs or lifestyle changes (for example, cessation of smoking), or a combination of both
- Find people at risk for future RA through simple methods, such as population-based blood tests or other approaches.
- Bring research and the medical community to agree on the right terminology for RA. "At the moment, PR is only applied when a person is suffering from arthritis. However, we may need to develop new terms, such as" Pre-PR. " that can be used to identify a person at high risk of future RA Diabetes is commonly used and helps people understand that they are at a stage of illness that indicates that they may become worse if they do not do not do anything, we need similar terms in PR that can reach people and help them get into action, "said Dr. Deane.
- The patient's preference is also a major challenge. "Asking people at risk to take medications with possible side effects when there is no clinically apparent disease is not easy at all," Dr. Cheung observes.
Many other rheumatic and autoimmune diseases follow a pattern similar to that of RA, where there are abnormal blood markers, sometimes years before the person feels "sick" from the disease. Lupus, gout and other diseases such as vasculitis.
"The science of RA is a lucky situation compared to many other inflammatory diseases where we seldom ignore when and where disease-specific immunity can be triggered and how it can progressively evolve towards targeting." final organ, "comments Lars Klareskog, MD, Rheumatology Unit, Department of Medicine, Karolinska Institutet and the Karolinska University Hospital, Stockholm, Sweden, in a guest editorial. "The research and solutions proposed in this issue may also serve as an example of many other chronic immune-mediated diseases."
Editor-in-chief Richard Shader, MD, Tufts University School of Medicine, Boston, MAUSA, comments: "The efforts of this team of experts to raise awareness of RA and to explore early detection and intervention methods should encourage medical and scientific communities to increase their efforts to find better ways to treat and respond to RA. perhaps even to prevent RA and its consequences, complications. "
Previous research has already shown that the development of RA can be delayed with a single dose of medication commonly used in people with complete RA. This discovery suggests that if individuals can be identified at the right time, a future PR can be delayed or completely avoided. Several ongoing clinical trials should also help determine which drugs can prevent RA and which are the best candidates to receive this treatment.
"Treating RA very early can lead to cheaper and safer treatments, because once PR is developed, very powerful medications are usually needed to control the disease – it's like setting a fire on fire. is still at the candle stage it's quite difficult.However, it is very difficult to stop a fire when a complete forest fire has developed! "conclude the guest editors.
Clinical Therapeutics Thematic Theme: Prevention of Rheumatoid Arthritis: Challenges and Opportunities for Changing the Paradigm of Disease Management
Guest Editors: Kevin D. Deane, MD, PhD, and Tsang Tommy Cheung, MBBS (HK)
Articles appear in Clinical Therapeutics, volume 41, number 7 (July 2019), published by Elsevier. All articles in this issue are freely available on www.clinicaltherapeutics.com. For more information, please contact Terry Materese at +1 215 327 9934 or [email protected]. To reach the invited editors or the authors of specific articles, contact Kevin Deane to [email protected] or Tommy Cheung to [email protected].
Sure Clinical Therapeutics
Clinical Therapeutics provides a rapid, peer-reviewed publication of recent developments in drug and other treatments, as well as pharmacoeconomics, health policy, treatment outcomes and innovations in drug and biologics research. In addition to the feature articles published each month, each issue of Clinical Therapeutics presents a specific thematic section dedicated to the annual update of a specific domain. A special guest editor will include each update with reviews, commentaries and original research highlighting novelties or controversies of the specialty. Clinical Therapeutics is read by a broad international audience of scientists and clinicians working in a variety of research, academic and clinical practice contexts. Articles are indexed by all major biomedical badysis databases. www.clinicaltherapeutics.com
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Elsevier is a global information badysis company that helps scientists and clinicians find new answers, reshape human knowledge and deal with the most urgent human crises. For 140 years, we have been working in partnership with the world of research to manage and verify scientific knowledge. Today, we are committed to bringing this rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of Strategic Research Management, R & D Performance, Clinical Decision Support and Vocational Training; comprising ScienceDirect, Scopus, SciVal, Clinical key and Sherpath. Elsevier publishes more than 2,500 digitized journals, including The lancet and Cell, 39,000 e-book titles and many iconic reference books, including Gray & # 39; s Anatomy. Elsevier is part of RELX Group, a global provider of information and badysis for professionals and business customers from all sectors. www.elsevier.com
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