Rheumatological diseases and false myths: they do not only affect the elderly and can be prevented

Nell’immaginario collettivo ancora molte false credenze circondano le malattie reumatologiche, che colpiscono 350 milioni di individui a livello globale e fino a 6,5 milioni nel nostro Paese. Prima fra tutte, quella secondo cui interesserebbero solo gli anziani. In realtà possono colpire anche persone giovani-adulte, donne in età riproduttiva, bambini. Altro ingombrante falso mito è quello secondo sui sarebbero ‘ineluttabili’. Sebbene la componente genetica rivesta un ruolo importante in molte malattie reumatologiche, è possibile cercare di prevenirle. Ma gran parte della popolazione non lo sa, non è consapevole del fatto che alcuni semplici comportamenti, come non fumare, avere una sana alimentazione, fare esercizio fisico e proteggersi dalle infezioni con i vaccini, possono ridurre il rischio di sviluppare le malattie reumatologiche o ritardarne la comparsa, soprattutto se in famiglia c’è già qualcuno che ne soffre. I familiari dei pazi

And in cases where preventing rheumatological diseases is not possible, their early diagnosis should be: innovation in recent years, in particular the dosage of certain biomarkers, such as auto-antibodies, makes it possible to intercept them even before they start producing symptoms. But this is often not the case. If not diagnosed and treated early, these diseases can lead to irreversible damage, with consequent health (drug treatment, hospitalisation and rehabilitation) and social costs (lost working days, reduced income, need for unemployment and disability benefits).

The problem of the diagnostic delay is linked to the lack of rheumatology specialists on the territory, whose number should be increased, and to the absence of networks that allow patients to be taken care of in the most appropriate care setting according to the complexity of the individual case. The training of general practitioners, who must be made aware of our pathologies, remains crucial. And PDTAs must be implemented that define an appropriate course of action in order to guarantee the best possible care for the patient.

Once the diagnosis has been confirmed, the patient should be referred to a rheumatologist and start treatment. Over the past 15 years, the pharmacological armamentarium for rheumatological diseases has become much richer, thanks to a deeper understanding of the mechanisms underlying them.

Today, the new frontier is called 'personalised medicine' and consists of trying to define the right drug, for the right patient, at the right time. Through precise investigations, biomarker analysis and tissue analysis, we can find the best drug for each individual patient, reducing the proportion of those who do not respond to therapy. It is an approach already used in other therapeutic areas that is beginning to be viable in rheumatology as well.