NewsHealthRheumatologist Lubrano: "Small molecules block psoriatic arthritis"

Rheumatologist Lubrano: “Small molecules block psoriatic arthritis”

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Psoriatic arthritis is not cured, “however, thanks to the new biotechnological drugs, the disease is extinguished to the point that the patient, even for a very long period of time, can lead a normal life, or almost. Among the target drugs, there is upadacitinib which belongs to the so-called “small molecules” which have an intracellular mechanism that blocks the pathways that normally activate inflammation. It is a selective molecule that has a very high safety profile and that allows you to be able to optimally control peripheral arthritis as well as dactylitis, a clinical manifestation characterized by the swelling of one or more fingers and toes caused by a underlying inflammation, entesitis, inflammation of one or more portions of the tendon, and inflammatory back pain, which are the typical manifestations of psoriatic arthritis. When it will have reimbursement in Italy too, upadacitinb is certainly one of those drugs that will be able to give a further therapeutic offer to patients suffering from psoriatic arthritis “. This was stated to Adnkronos Salute by Ennio Lubrano, full professor of Rheumatology at the University of Molise, one of the protagonists of the 58th National Congress of the Italian Society of Rheumatology (Sir) which has just ended. “At the center of the Congress – recalls Lubrano – a series of communications and studies about the arrival of new therapeutic targets, that is biotechnological drugs that are very effective in controlling the various manifestations of psoriatic arthritis, a condition among the most studied today because there is a great interest and because the margins of early diagnosis and treatment compared to 15-20 years ago have changed enormously “. In Italy the disease affects “about 500 thousand people, equal to 0.4% of the population – underlines the rheumatologist – It is certainly a pathology that most often complicates psoriasis which is also a very widespread disease, not surprisingly it affects 1.5 million Italians (2-3% of the population) “. Like all forms of arthritis, it most often presents itself as inflammation of the joints: pain and functional limitation of the peripheral joints (hands, wrists, knees, ankles) and back are the hallmarks of the disease. “Then there are enthesitis – explains Lubrano – or the pain of that portion of the tendon (such as the Achilles tendon or the elbow tendon) and dactylitis, an inflammation of a finger or foot that resembles the shape of a sausage “. Patients who already have psoriasis, which is a disease of the skin and nails (nail psoriasis), at the onset of “any manifestations – again Lubrano – such as pain, even without real inflammation of the peripheral joints rather than the spine vertebral or tendon, they could ask the general practitioner for an evaluation by a rheumatologist specialist “. At the first alarm bells, therefore, the patient “must contact the rheumatologist and not the orthopedist – recommends Lubrano – because arthritis are diseases of the musculoskeletal system, therefore the responsibility of the rheumatologist, a specialist in these diseases who has the knowledge of both clinical manifestations and pathogenetic mechanisms but also of what the cognitive contribution can be for diagnosis and treatment. The orthopedist, on the other hand, is a surgeon who generally deals with the surgical part of all musculoskeletal diseases “. The diagnosis is clinical: once the symptoms have been assessed, the doctor requires some laboratory tests and imaging methods (ultrasound, magnetic resonance). “Sometimes immunogenetic tests are performed – he explains – as they allow us to comprehensively evaluate and intercept the characteristics of the disease and allow for diagnosis”. Although the disease does not heal, “today we have effective and powerful drugs thanks to which psoriatic arthritis is extinguished to the point that even for long periods the patient forgets his condition. If taken on time and taken carefully and for a specific period of time, these biotechnological drugs significantly improve the quality of life and therefore allow people to live normally “, concludes the expert.

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