“For lupus patients waiting for diagnosis up to 2 years”

2023-05-10 16:32:00

One disease, various symptoms and multiple organs involved. It is systemic lupus erythematosus (SLE) which affects 21,000 people in Italy, especially women of childbearing age, who are forced to live with joint pain, skin manifestations, swelling of the joints, fever, tiredness, loss of appetite and anemia on a daily basis. “All non-specific symptoms, for this reason lupus can be very difficult to identify at its onset. It is no coincidence that the patient waits 20 months for a diagnosis, almost two years which in my opinion are really too many”. Thus Gian Domenico Sebastiani, president of the Italian Society of Rheumatology (Sir) in his speech at the press conference “Systemic lupus erythematosus, the new treatment opportunities”, promoted today in Rome on the occasion of World Lupus Day to take stock of the important therapeutic innovations currently available to check the illness.

At the first alarm bells, including skin rashes and alterations in blood and urine tests, “the first approach – warns Sebastiani, who is also director of the Rheumatology Unit of San Camillo – is with the general practitioner who will be able to recognize these symptoms and will have to refer the patient to the rheumatologist specialist in the suspicion of SLE. The family doctor will also have to prescribe some basic routine tests, such as blood counts and urine tests”. The musculoskeletal, skin, hematological organs, kidneys, central nervous system “are among the targets” preferred by “systemic lupus erythematosus – explains the expert – but SLE can virtually involve any organ and system of the human body. For this reason it is the rheumatological pathology but in general the most complex and serious disease that requires a multidisciplinary approach, with a dermatologist, hematologist, rheumatologist, nephrologist, interventional radiologist, cardiologist, gastroenterologist, pulmonologist, with the technology that we have available in the centers of reference within the hospital structures”.

After the diagnosis “it is necessary to evaluate which organs are involved – underlines Sebastiani – and to establish the disease activity. Therefore prescribing a pharmacological treatment which today is mainly based on the use of glucocorticoids which, however, have important side effects, above all on another problem of SLE which is the accumulation of damage. So we have to be good at reducing disease activity without using too much cortisone.” The drugs “at our disposal, including the monoclonal antibody anifrolumab allow the disease to be put into remission, total recovery is currently not an achievable goal”.