Rheumatoid arthritis in Latin America: the importance of an early diagnosis.

Licia Maria Henrique Da Mota,Claiton Viegas Brenol,Geraldo Da Rocha Castelar Pinheiro,Penelope Palominos

doi:10.1007/s10067-015-3015-x

Abstract

The generalization of the early rheumatoid arthritis (ERA) concept and the existence of a window of therapeutic opportunity—a time span in which the institution of a proper therapeutic method for the disease would determine clinical improvement—have set the notion that early diagnosis and treatment may modify the course of the disease. Although in several regions of the world, especially in North America and Europe, since the year 2000, a significant reduction in diagnostic delay was observed in cohorts of patients with rheumatoid arthritis (RA), probably reflecting a stronger awareness of the importance of early diagnosis, this is not a reality in Latin America (LA). LA is a region of great economic inequality, with disparities in access to the public healthcare system and limited access to private medicine, being widely difficult to obtain a specialized medical evaluation in both scenarios. This paper aims to briefly review the main difficulties in the management of ERA in LA, based on the review of the literature, on the evaluation of a survey conducted among 214 rheumatologists of LA, members of Pan-American League of Associations for Rheumatology (PANLAR) and the experience of the authors. The paper also aims to propose solutions to the difficulties in managing ERA in LA.

Highlights

Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disease characterized by joint swelling, joint tenderness, and destruction of the synovial joints that can lead to severe disability and premature mortality
This paper aims to briefly review the main difficulties in the management of Early RA (ERA) in LA, based on the review of the literature, the evaluation of a survey conducted among Latin American rheumatologists members of Pan-American League of Associations for Rheumatology ) and the experience of the authors
Electronic Library Online) using terms related to early arthritis and, in PubMed, combining them with country names or regional names related to Latin American and the Caribbean Islands

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disease characterized by joint swelling, joint tenderness, and destruction of the synovial joints that can lead to severe disability and premature mortality. There was a clear evolution in knowledge about physiopathology of the disease, resulting in changes in its approach and treatment. RA (ERA) is defined as the diagnosis given in the first weeks or months of joint symptoms or signs. The generalization of the ERA concept and the existence of a window of therapeutic opportunity—a time span in which the institution of a proper therapeutic method for the disease would determine clinical improvement—have set the notion that early diagnosis and treatment may modify the course of the disease [3]

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