Profilaksa DVT kod velikih ortopedskih operacija - Depol ...

20 - 22 September 2012, Opatija, Croatia
THE FUTURE OF RHEUMATOID ARTHRITIS TREATMENT -
COMBINING PHARMACOLOGY AND SURGERY
Dušanka Martinović Kaliterna, Department of Rheumatology and Clinical Immunology, University
Hospital of Split, Split, Croatia
Rheumatoid arthritis (RA) is widespread and complex multifactorial chronic inflammatory disorder with not always
successful treatment. A great success of RA pharmacotherapy is characterised by novel genetically engineered
biological medicines. The hallmark of RA is chronic synovial inflammation which leads to joint damage and
destruction. The role of cytokines is important not only for local synovial autoimmune response but also for systemic
features. In the last decades the cytokines role is stressed in RA especially tumour necrosis factor alpha and
interleukins. Achievements of molecular biology and genetics promote an individual approach to RA treatment,
with a new concept of personal medicine in the view of genomic sciences. Personalized genomic medicine and
surgery represents a new approach to health care that customised patients’ medical treatment according to their
own genetic information. Genomic information can also indicate the potential risk for certain diseases before the
patient is symptomatic. It is clear that differences in genomes of individuals would likewise affect the effectiveness
of medication.
We are aware that although we have the choice of new biological drugs, it is not always effective. In the beginning
of the disease the bone biopsy is sometimes needed for evaluating the disease, and later the cooperation with
orthopaedist is mostly based in purpose of arthroscopy. Off course in some progressive RA cases surgical reconstruction
and joint replacement may not be avoided.
While the progress in DNA sequencing has been extensive in the last years, it promote the great challenge for
utilizing genomic information for choosing the future more effective pharmacological and surgical therapy in RA.
Oral
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