2023-11-27 17:08:00
It is a journey that involves institutions, clinicians and patient associations, in search of the best solutions for the management and assistance of people suffering from chronic immune-mediated inflammatory diseases, the project ‘CRONIStorie – An open dialogue on the immunology of the future ‘, by Janssen, a pharmaceutical company of the Johnson & Johnson group. As part of the awareness campaign, presented today in Rome, some regions have been identified that are standing out for excellent projects with the aim of defining the best strategic lines for citizens affected by these pathologies.
In this roadmap – explains a note – alongside Friuli Venezia-Giulia and Veneto, in which two peculiarities have been highlighted – respectively the creation at the Santa Maria della Misericordia hospital in Udine of a clinic shared between dermatologist and rheumatologist and the project of a working group to define the first Pdta (diagnostic therapeutic care pathway) for the management of chronic intestinal inflammatory diseases, the 2023 campaign now reaches the Lazio region.
Over 5 million Italians (1 in 10 adults) live with immune-mediated inflammatory diseases such as inflammatory bowel diseases, psoriasis and psoriatic arthritis, the prevalence and severity of which are often underestimated. In fact, these pathologies have a very important impact on the lives of patients: pain, tiredness and inability to carry out daily activities are only the most obvious symptoms. Many times those who suffer from these diseases tend to isolate themselves, not being able to fully live their social or working life, with a consequent decrease in productivity, anxiety, stress and psychological repercussions, even leading to depression. Furthermore, more often than not, it is not just the patients who pay the price, but also their families and their entire circle of close contacts.
“Chronic intestinal inflammatory diseases (CID), Crohn’s disease and ulcerative colitis – explains Flavio Caprioli, General Secretary Ig-Ibd, Italian Group for the study of Inflammatory Bowel Disease – which affect the digestive system, can arise in any range of age, including pediatric age”. They affect around 250 thousand Italians, “but the number is destined to double in 10 years. They determine – he continues – chronic disabling intestinal symptoms with symptoms sometimes associated with manifestations in other systems, such as the joints or the skin. Currently available IBD therapies are effective in controlling symptoms and disease progression in more than half of patients. However, it is sometimes necessary to resort to surgical interventions with resection of intestinal tracts to control the inflammation and complications of IBD, including the possible onset of tumors. For this reason, it is appropriate to study new therapeutic strategies, including the search for predictive markers of response to therapies, which are currently not available. Patient management represents another critical area, with particular regard to the territorial care of patients in remission or with mild symptoms, through the specific training of general practitioners or outpatient specialists”.
“Psoriasis – says Ketty Peris, Sidemast advisor, Italian Society of Dermatology and Sexually Transmitted Diseases – is a chronic relapsing skin disease that affects approximately 2 and a half million people in Italy. It is caused by immune-mediated inflammation and is characterized by erythematous-desquamative skin lesions. More than half of people affected by psoriasis live with other diseases, such as diabetes, psoriatic arthritis, some heart diseases and depression. There is no cure, but with treatment it is possible to keep clinical manifestations under control, even for long periods. It is essential to try to optimize organizational models also to avoid bureaucratic obstacles and ensure that the patient is taken care of in adequate times, facilitate access to therapies and encourage therapeutic continuity”.
“Rheumatic diseases – highlights Maria Sole Chimenti, SIR member, Italian Society of Rheumatology – include chronic inflammatory pathologies that affect the joints but also organs and systems such as the skin, intestine, cardiovascular system and the emotional sphere. Among these, psoriatic arthritis is a specific form of chronic inflammatory arthritis, often associated with psoriasis. In Italy it affects around 40 people per ten thousand inhabitants: up to a third could also be affected by psoriatic arthritis. It is essential for those suffering from a chronic immune-mediated inflammatory disease to be able to turn to a specialized center for the pathology in a short time, where dermatologists and rheumatologists collaborate in a synergistic and multidisciplinary approach in the management of the patient” for a management profiled on the quality of life and ability to adhere”.
For IBD, “also increasing in pediatric age – continues Alessia Amore, deputy director of Amici Ets, National Association for chronic inflammatory diseases of the intestine – a greater investment in scientific research is desirable to better understand these pathologies and develop new therapeutic approaches. It is important to raise awareness among the institutions of the importance of investing necessary resources”. As Valeria Corazza, president of the Corazza Onlus Foundation and Apiafco, Italian psoriasis association Friends of the Corazza Foundation, recalls, the association “presented a charter in 2020 with the unmet needs of patients which include: including psoriasis in the chronicity plan, reviewing the Lea (Essential levels of care, ed.) and allow all patients to have exemption, organize multifactorial management since psoriasis is a complex disease. Nothing has been done since then. The drugs are very effective, but it is essential to guarantee uniform access to them in all regions of Italy.”
In the case of psoriatic arthritis, “it is essential to be able to have access to local assistance without long waits and timely management by the reference specialists, dermatologist and rheumatologist – reiterates Antonella Celano, president of Apmarr, National Association of people with rheumatological diseases and rare – Starting from the diagnosis the patient needs to be informed, reassured and assisted, and made an active participant in his own diagnostic and therapeutic path such as an association of other patients and the involvement of a psychologist”.
“At Janssen, research in immunology has always been at the forefront – concludes Elisabetta Grillo, Therapeutic Area Medical Head Immunology Janssen Italy – Since the advent of biological therapies, which occurred more than 30 years ago, we have developed the first monoclonal antibody aimed at the immune system, providing patients with an effective solution, capable of acting significantly also on symptoms. We have therefore continued to expand our knowledge of the inflammatory process and, thanks to this, we have been the first to develop therapies that intercept new inflammatory pathways and which can substantially improve patients’ lives. Our discoveries have changed the lives of millions of people around the world, and we continue to work towards better treatments that can stop and even cure immune-mediated diseases.”
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