Such as tablets for rheumatism to help
The joints hurt and are swollen, the fingers are stiff and movements are especially in the Morning is difficult: people with rheumatism are restricted in everyday life frequently strongly by their complaints. Around half a million people in Germany suffer from the so-called rheumatoid Arthritis, an inflammatory rheumatic Form.
A series of most elaborate therapeutic approaches to alleviate the problem: With physiotherapy, electrotherapy, or a variety of preparations, rheumatologists have achieved in the past successes.
But since a short time there is for patients with inflammatory rheumatic diseases, a less complicated treatment option: For about two years, Doctors can prescribe in Germany in the medium, the reaction in rheumatoid Arthritis suppress the autoimmune.
The so-called Janus kinase inhibitors prevent certain messenger substances (cytokines) that trigger the cell membrane, a signal chain that leads Inside the cell for the production of new inflammatory substances. The inflammatory materials cause in the musculoskeletal system, but also to the heart and lungs severe damage and pain.
There is already biologics, genetically engineered proteins, which are in effect outside of the cell, the messengers. These funds were approved since 1998, in Germany, says Hendrik Schulze-Koops, President of the German society for rheumatology. Since then, the inflammatory rheumatic diseases have lost their terror. In the eighties, patients have died on average ten years earlier than the General population. Meanwhile, their life expectancy is aligned with the average. They may even play sports.
Biologics, however, have a disadvantage: they must be injected under the skin or into the bloodstream. Doctors do not use it, among other things, therefore, as the first remedy in inflammatory rheumatic diseases. Who goes with pain to the doctor, get a rule, first of all, cortisone, which reduces the activity of the immune system. “If it burns, you’ll be glad when the fire and get water,” says Schulze-Koops. Then the gift of hydroxychloroquine or methotrexate usually. The a is actually a malaria drug, a tumor drug. In very low doses, you might bring the inflammation to a standstill, but usually only after a few weeks or more.
The newer Janus kinase inhibitors, including JAK inhibitors can swallow patients, in contrast to biologics, just as a tablet. The head of the section of rheumatology and inflammatory diseases at the University hospital Hamburg-Eppendorf (UKE), Ina Kötter, a rating of the agent as the essential progress in the rheumatism therapy.
Another advantage of the could make in a few years: the cost. Currently, treatment with biologics is the cost, according to Schulze-Koops between 12,000 and 25,000 euros per year. The JAK-inhibitor are similar to expensive treatment costs, according to Kötter around 15,000 to 18,000 euros. However, the patent of protection for the funds within seven or eight years. Then cheap imitators could be made medicines. The production of biologics will remain, however, with a huge effort.
The search for the Holy Grail
A healing rheumatic inflammatory diseases is not yet possible, even with the new JAK inhibitors. “We are still looking for the Holy Grail,” says Schulze-Koops. Crucial for the success of a therapy, the early diagnosis is. Who am prone, did not pain the same joint, but symptoms like the flu: fever, night sweats, loss of Power, feeling of fatigue.
If inflammation exists, it must clarify a rheumatologist quickly. The probability of treatment success decreases per week to one per cent. From the first symptoms until the first visit to the rheumatologist lapse of eight months in the case of rheumatoid Arthritis, however, in the case of ankylosing spondylitis, a disease mainly of the spine, even five to seven years. At least that was the result of a study from the year 2016.
Therefore, the society for rheumatology calls for better early detection and care structure. It is 600-based rheumatologist in Germany, lacked Schulze-Koops says.