From osteoarthritis to rheumatoid arthritis, these pathologies can compromise independence and work at any age. In Italy 734,000 people live with serious and disabling forms: today is World Rheumatological Diseases Day
More than ten million Italians live with one rheumatological disease. In Europe there are 120 million. Huge numbers, yet the topic remains little known, even though these pathologies are among the main causes of chronic pain and disability. October 12th marks the 30th World Day dedicated to these pathologies. For the occasion the Italian Society of Rheumatology (SIR) presents the new White Paper. The volume collects epidemiological, social and economic data and indicates how to guarantee patients fair and timely care.
Rheumatological diseases: over 10 million Italians involved
They affect children and elderly people, regardless of age. Often, however, they arise at the height of working and reproductive age, that is, in the years in which a career and family are being built. The European picture confirms the dimension of the phenomenon. Of the 120 million Europeans involved, there are over 10 million Italians. Every medical history is different, but chronic pain and risk of disability are a common trait. This is why rheumatologists talk about an issue that goes beyond the doctor’s office. The SIR White Paper puts the numbers together and reads them from a social and economic perspective. At stake are the health of patients, but also the jobs and finances of the country. The document is not limited to photography. It also illustrates the priority lines of intervention identified by Italian rheumatologists. The goal is truly fair and timely access to the most appropriate care. Andrea Doria, president of SIR, insists on one point: «Rheumatological diseases are not a destiny of old age and pain, but a major public health issue that affects all ages». Today, he adds, thanks to progress in research it is possible to tackle them with tools that were unthinkable until a few years ago.
More than 200 pathologies: it’s not just bone pain
The term “rheumatism” often evokes pain in the knees or back in old age. It’s a reductive idea. Doria corrects her: «Rheumatology is not limited to joints of advanced age: it deals with over 200 conditions». The chapter includes inflammatory, degenerative and osteo-metabolic diseases. Then there are numerous autoimmune diseasescapable of involving the skin, lungs, kidneys, heart, digestive system and nervous system. In an autoimmune disease, the immune system attacks the body’s own tissues. This explains why the clinical picture can be very varied. The same disease can affect the skin, lungs or kidneys, as well as the joints. The most widespread are known. THE’arthrosis it affects approximately 8.7 million people. THE’osteoporosis it has around 5 million cases. There fibromyalgia it has almost 2 million.
They follow spondyloarthritiswith approximately 600,000 patients, and therheumatoid arthritiswith 320,000. Overall, there are over 1 million people with inflammatory diseases of the joints and spine. Approximately 734,000 exhibit severe and disabling forms. These are cases in which the disease seriously affects daily life.
Women, children and workers: who pays the highest price
Women are the most affected. Patients with ticket exemption for chronic disabling rheumatological diseases there are approximately 371,000. 68% are female. More than half are between 45 and 65 years old. It is the period of full working age. Doria gives a face to these figures. Behind the numbers, he recalls, “there are people: young women who find themselves sick at childbearing age, workers who at 50 risk losing autonomy and employment, children who grow up with a chronic illness”. In fact, rheumatological diseases do not spare the little ones. THE’juvenile idiopathic arthritis it has a prevalence of between 16 and 150 cases per 100,000 inhabitants in the pediatric population. Many forms persist into adulthood. This is why it is important to ensure correct transition between pediatric and adult services. The transition from one to the other, therefore, should not be left to chance.
The income statement: over 4 billion euros a year
The economic burden of rheumatological diseases is significant. For the alone rheumatoid arthritis the cost is estimated to exceed 2 billion euros per year. Of these, approximately 900 million are indirect costs. It is a very large share of the total. The picture broadens by considering together rheumatoid arthritis, psoriatic arthritis And ankylosing spondylitis. Approximately 23.2 million days of work lost each year have been quantified for these three diseases. The overall economic impact exceeds 4 billion euros. Behind these estimates there are not only healthcare costs. There are hours of work not done and people who struggle to stay employed. If you look at the age of patients with exemption, the connection with professional life is evident. The White Paper brings together health, social and economic data, and this connection emerges clearly.
Early diagnosis and biological drugs: what has changed
The most encouraging chapter concerns treatments. «Until a few years ago, many of these diseases almost inevitably led to disability», underlines Roberto Caporali, president-elect of SIR. Today the scenario is different. Thanks to biological drugs and at targeted therapiesthe remission or low disease activity are achievable goals for an increasing number of patients. Times matter a lot. In the early stages of many inflammatory rheumatological diseases there is a “window of opportunity”. In that period the treatment is more effective in modifying the course of the pathology.
For this reason the early diagnosis it is decisive. Intervening promptly, explains Caporali, allows you to reduce joint and organ damage, disability, work disability and indirect costs. The message from rheumatologists is clear: timeliness and access to appropriate care go together. The White Paper revolves around these two points. The thirtieth anniversary of World Day, concludes Doria, will be “the opportunity to tell it”.
Rheumatoid arthritis: information as part of the treatment
Among the initiatives linked to the World Day is the campaign Value for Carepromoted by Alfasigma in collaboration with ANMAR (National Association of Rheumatic Patients), which launched the online educational platform valueforcare.it, aimed at those living withrheumatoid arthritis. It offers animated video stories and video interviews with specialists on early diagnosistreatments and management of the disease. If not treated adequately, the disease causes significant joint pain and functional disability. The point, the promoters remind us, is that an informed patient participates better in decisions and follows therapies with more continuity. According to the president of ANMAR, Silvia Tonolo, sustainability does not coincide with simple savings, but with the ability to guarantee appropriate care to everyone, regardless of place of residence and economic conditions. Florenzo Iannone, director of Rheumatology at the Bari Polyclinic, adds that personalizing therapy not only serves to extinguish inflammation, but to preserve quality of life: work, daily activities, relationships.
