Personalize rheumatoid arthritis (RA) treatment paths by putting the patient-person at the center with all his clinical, social and relational needs. This is the request shared by 79% of patients with Ar, convinced that this is the main path to guaranteeing a better quality of life, understood as psychosocial well-being correlated to a good level of functionality, central aspects for a chronic pathology that very often accompanies to comorbidities. This is what emerges from the survey conducted on patients and clinicians which gave rise to the Position Paper “Innovating the care of the person with rheumatoid arthritis: from unmet needs to personalization of care” created by Altems Advisor – Faculty of Economics Università Cattolica del Sacro Cuore with the patronage of Anmar – National Association of Rheumatic Patients Odv and of Apmarr – National Association of people with rheumatological and rare diseases, and with the non-conditioning contribution of Alfasigma.
The aim of the Paper, presented today to the Senate of the Republic on the initiative of Senator Elena Murelli, is to highlight the needs currently unsatisfied in the management of RA and bring to the attention of the Institutions concrete ideas and models to design an ideal diagnostic-therapeutic path, thanks to strategies based on the person, on the virtuous relationship with the territory, and on the ability to effectively and appropriately harmonize the therapeutic resources available.
“The management of rheumatoid arthritis requires early diagnosis, timely intervention and a holistic approach that considers not only the clinical aspects, but also the psychological and social ones – highlighted Senator Murelli of the 10th Permanent Commission on Social Affairs, Health, Public Work and private, social security – We intend to embrace and underline the need for a radical change in the treatment paths for patients suffering from rheumatoid arthritis. We want to guarantee these patients not only faster and easier access to innovative therapies, but also constant support throughout their treatment path, which must be increasingly personalized and responsive to the specific needs of the individual, also considering the structural damage and the various comorbidities that rheumatoid arthritis also entails”.
The survey, developed by a multidisciplinary working group made up of clinicians, patient associations, pharmacologists and pharmaco-economists, involved 67 healthcare professionals and 70 patients with rheumatoid arthritis. Early identification of the diagnosis, communication between family doctors and rheumatologists, effective management of comorbidities, reorganization of care services, access to innovation are among the main unmet needs in the management of rheumatoid arthritis indicated with different scores by specialists and patients.
34% of patients – reports a note – believe they have not received a timely diagnosis, compared to 32% of doctors who believe that early identification of symptoms is a common practice. While almost half of healthcare professionals (44.78%) positively evaluate the efficiency in managing comorbidities, only 27.91% of patients share this perception. A significant proportion of patients (20.93%) express dissatisfaction, highlighting a potential discrepancy between clinical assessment and patients’ experience in managing comorbidities in rheumatoid arthritis. Almost half of healthcare professionals (47.76%) believe that strengthening local medicine can significantly improve the management of rheumatoid arthritis; but only a minority of patients (23.26%) perceive the current support at a local level as adequate.
“The advantages of personalized care that puts the person’s specific needs first are clear. Personalizing the treatment based on clinical conditions and lifestyle improves the effectiveness of the treatments” states Filippo Rumi, Altems Researcher, Co- founder & Partner Altems Advisory, Catholic University of the Sacred Heart.
The incidence of rheumatoid arthritis is 2-4 new cases per year per 10,000 adults. It affects women more than men with a ratio of 3-4:1, and in an age range between 40 and 60 years. The patient with Ar must live with the disease and its treatments all his life and adherence to therapy therefore has a fundamental role, recognized almost equally by both healthcare professionals and patients. Approximately half of the patients, however, appear not to be completely satisfied with the therapeutic plan, and this element underlines the need to review and optimize therapeutic approaches to improve the overall outcomes of the treatment.
Related to this theme is that of regional disparities in access to resources and services for rheumatoid arthritis recognized by both groups: patients (32.56%), doctors (35.82%). Patients – the note details – perceive differentiation more. Inequalities risk compromising patients’ access to innovative therapies such as Jak inhibitors (Janus kinase inhibitors), a class of drugs recently introduced in the therapeutic panorama of Ar, to be used based on appropriateness criteria, through accurate evaluation of the patients who can most benefit from it. Although a significant percentage of patients (41.86%) believe they have access to the most appropriate therapy, expressing themselves with high scores, a non-negligible share, 20%, evaluates this accessibility negatively, indicating the need to improve adaptation and personalization of treatment.
“Alfasigma’s commitment is to improve the quality of life of patients with rheumatoid arthritis by promoting adherence and personalization of treatment. – states Stefania Bassanini, Head of Medical Affairs of Alfasigma Italia – The interdisciplinary approach in taking charge is fundamental of the patient, who must be treated appropriately in all phases of the pathology, from the beginning to the most serious cases, when pain and disability are constant companions of life. Bassanini concludes: Today, as Alfasigma, we are proud to offer a range of therapeutic options complete and attentive to the unmet needs of patients I think that the future of rheumatoid arthritis management lies in the integration of effective therapies and tools based on Artificial Intelligence, capable of analyzing data and carrying out careful staging of patients, with undoubted benefits in terms of clinical and social outcomes”.
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