The early intensive treatment of the rheumatoid arthritis can stop the progression of the disease.

On 1 October is celebrated the day national of arthritis Rheumatoid.

-The Spanish society of Rheumatology (be) has developed a consensus on biological therapies in rheumatoid arthritis that updated the guidelines before this disease with these innovative drugs

-the combination of methotrexate with biological agents such as the anti-TNF (tumour necrosis factor inhibitors) since the earlier possible are the most desirable treatment

-present There are no data to suggest that an anti-TNF is superior to another, so the choice depends on both the criterion of the doctor and the particular circumstances of the patient

-the complete healing of rheumatoid arthritis is an utopia at the present time. On the other hand, only 40-50% of patients achieved remission of the disease

Madrid, September 2009.- rheumatoid arthritis cure is today still a utopia despite the strides that recent years have taken place in the treatment of this disease. For this reason, and in order to be able to reach the remission of the rheumatic condition as soon as possible, the rheumatologists recommend an early intensive treatment with current therapies.

Thus indicates it consensus on biological agents which has produced the Spanish Rheumatology society (be), and updated the guidelines indicated in the last consensus made in 2006.

Rheumatoid arthritis affects already in our country more than 250,000 people, which means that it is suffering around 0.5% of the adult population in Spanish. It’s a progressive inflammatory disease which damaged joints, which makes the patient gradually lose functionality, and therefore see seriously reduced their quality of life.

The most prominent novelties of this consensus indicate that the best treatment for the rheumatic condition is a combination of drug disease (FAME) such as methotrexate – standard therapy for the treatment of rheumatoid arthritis – with biological agents such as the anti-TNF (tumour necrosis factor inhibitors) from the earlier time possible.

On the other hand, this document also indicates that the most optimal result is needed to achieve access to specialized treatment, something that can be achieved through units of rheumatoid arthritis early, put in place by the Spanish society of Rheumatology, and available now in various hospitals.

The objective of addressing the disease from the earliest stages is achieved remission or lesser degree of activity of the same, according to the panel of experts of the being that he has participated in the development of this consensus.

What are biological therapies?

Biological therapies – designed to ensure that they act on a specific therapeutic target – have made a breakthrough in the treatment and control of the progression of rheumatoid arthritis, what he has done that specialists have even changed the therapeutic strategy.

But despite the progress that these new drugs have been, we must bear in mind that still do not get an optimal response in more than 40-50% of patients, that they cease to be effective over time.

On the other hand, due to the first step in the treatment of the disease due do with FAMEs, specialists advise to integrate them into a comprehensive therapeutic strategy of pathology. Thus, this consensus indicates that therapy that more must be taken into account in the treatment of rheumatoid arthritis remain FAMEs as methotrexate and the leflunomida.

Early with anti-TNF treatment

There are currently seven biological agents aimed at the treatment of rheumatoid arthritis, three of them are anti-TNF and four others aimed at specific therapeutic targets with an important role in the disease process. Different studies have shown that the anti – TNF are superior to methotrexate monotherapy and in controlled studies have been makes early treatment with this type of biological agents that it can reach a lasting remission.

Given that there are no data to indicate that an anti-TNF is superior to another, this consensus developed by SER indicates that the three types of drugs are necessary, but not substitutable between themselves, as well as the choice depends on both the criterion of the doctor and the patient’s particular circumstances. Though as they have different structures and mechanisms of action, the lack of response to one of them does not imply that the rest will be ineffective.

This document makes very clear that the use of a biological agent must be accompanied at the outset of a FAME, and will only be used as sole therapy initial in extraordinary cases. In this way, these biological therapies is only administered in monotherapy in patients where this first treatment has failed the therapeutic goal.

Detailed tracking

The use of this type of biological drugs requires, as it indicates this consensus, of a regular assessment of the evolution of the patient, which should be reduced to 3 months if not get the expected objectives or increase to 6 If the evolution is positive.

The consensus places great emphasis on not combine two biological drugs, they are of the type that are. This contraindication is because that increases the risk of the patient to develop infections while there is a clear advantage in its effectiveness.

In the same way, it also insists on not opt for this type of therapy in patients with active infections or with a history of them, as well as those who suffer from tuberculosis or which are in contact with people who suffer from this disease.

Spanish society of Rheumatology (be).

The Spanish Rheumatology society (be) is a scientific association which aims to promote the study of rheumatic diseases – diseases of the musculoskeletal system and connective tissue – for the benefit of patients and to address problems related to the specialty. SER currently represents nearly 1,500 professionals in Spain and maintains contact with regional societies of Rheumatology from across the country. SER develops work, studies and research projects in rheumatology by the Spanish Foundation of Rheumatology (FER) and provides support to patients of rheumatic diseases through his relationship with associations comprising mainly patients as the LIRE (Rheumatology Spanish League)CONFEPAR (Confederation of patients Reumáticos), ConArtritis (national coordinator of arthritis) or the Spanish Forum of patients.