The past 20 years have seen a real revolution in the treatment of chronic rheumatic diseases such as arthritis and spondyloarthritis. More sophisticated treatments (biopharmaceuticals) can prevent visible joint deformities, but many invisible injuries often remain intact. In addition, lifelong treatment is necessary and these therapies can also have side effects.
“Invisible injuries are limitations that are the result of the disease, such as fatigue or pain. For example, people who have a physically demanding job or who work in a shift system and are affected by rheumatoid arthritis can often find it difficult to do their job. Continuing to perform at the same level as before is usually impossible because your energy level is no longer the same,” explains rheumatologist Prof. Filip De Keyser. “That can lead to frustration or misunderstanding, because it is not always obvious to explain such invisible limitations to your employer.”
Three step therapy
Medication is an important part of the treatment of chronic forms of arthritis and takes place in steps. “The initial therapy is purely symptomatic, using mainly aspirin-like anti-inflammatory drugs (NSAIDs) such as ibuprofen. These relieve the stiffness and have an analgesic effect, but they do not affect the underlying processes involved in joint damage. In acute flare-ups and severe pain, cortisone derivatives are used. (prednisolone ea.) for their strong and fast-acting anti-inflammatory effect, but because they do generate some harmful side effects in the long term, they are used for as short a time as possible.”
At the same time as the cortisone treatment, a basic therapy is also started in certain forms of rheumatism such as rheumatoid arthritis or psoriatic rheumatism. “Preparations such as methotrexate are used that address not only the complaints but also the underlying inflammatory mechanism. This effect usually takes more than 8 weeks, making it unsuitable for an acute flare-up. Once at cruising speed, this is sufficient for more than “Half of people are treated with this drug. Methotrexate is usually combined with folic acid (a B vitamin) to increase the safety and good tolerance of the treatment.”
Biologicals
In about 3 in 10 the basic therapy fails and so a little more is needed. “The so-called ‘biologicals’ provide a solution for this group. This innovative medication consists of complex molecules that have a targeted effect on a specific biological target. In this way they attack the mechanisms of origin of the autoimmune disorder at the molecular level. not a miracle solution because not every biological works equally efficiently for every patient with a form of inflammatory rheumatism. The range of biologicals has grown continuously in recent years, so that more and more people can receive a suitable therapy with as few side effects as possible. we put the disease into remission”, emphasizes Prof. De Keyser.
“Invisible injuries are limitations that are the result of the disease, such as fatigue or pain. For example, people who have a physically demanding job or who work in a shift system and are affected by rheumatoid arthritis can often find it difficult to do their job. Continuing to perform at the same level as before is usually impossible because your energy level is no longer the same,” explains rheumatologist Prof. Filip De Keyser. “That can lead to frustration or misunderstanding, because it is not always obvious to explain such invisible limitations to your employer.” Medication is an important part of the treatment of chronic forms of arthritis and takes place in steps. “The initial therapy is purely symptomatic, using mainly aspirin-like anti-inflammatory drugs (NSAIDs) such as ibuprofen. These relieve the stiffness and have an analgesic effect, but they do not affect the underlying processes involved in joint damage. In acute flare-ups and severe pain, cortisone derivatives are used. (prednisolone ea.) are used for their strong and fast-acting anti-inflammatory effect, but because they generate some harmful side effects in the long term, they are used for the shortest possible time. also started basic therapy. “Preparations such as methotrexate are used that address not only the complaints but also the underlying inflammatory mechanism. This effect usually takes more than 8 weeks, making it unsuitable for an acute flare-up. Once at cruising speed, this is sufficient for more than “Half of people are treated with this drug. Methotrexate is usually combined with folic acid (a B vitamin) to increase the safety and good tolerance of the treatment.” In about 3 in 10 the basic therapy fails and so a little more is needed. “The so-called ‘biologicals’ provide a solution for this group. This innovative medication consists of complex molecules that have a targeted effect on a specific biological target. In this way they attack the mechanisms of origin of the autoimmune disorder at the molecular level. not a miracle solution because not every biological works equally efficiently for every patient with a form of inflammatory rheumatism. The range of biologicals has grown continuously in recent years, so that more and more people can receive a suitable therapy with as few side effects as possible. we put the disease into remission”, emphasizes Prof. De Keyser.