Painful lesson for rheumatism patients

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Pain in inflamed joints.
Image: obs

Tailor-made therapies are the grail of therapy. Every patient is treated differently. Rheumatism shows how arduous the path can be.

AWhen the first targeted drug for rheumatism came on the market in 1998, it was a breakthrough for many doctors and patients in the treatment of the painful and difficult to treat inflammatory process. The medications – so-called biologics – lead to faster relief of the complaints, many patients now live longer with a good quality of life and can work again – an important factor also in economic terms. But it was not a universal solution. Again and again there are patients for whom biologics have a bad effect. Now scientists from the German Rheumatism Research Center in Berlin have found a possible, decisive explanation: certain biologics do not work so well for fat people. “Earlier studies already indicated this factor, but I was surprised that the effect is so great,” says Hanns-Martin Lorenz, head of rheumatology at Heidelberg University Hospital.

The classic standard therapy for rheumatoid arthritis is initially methotrexate in combination with cortisone. If the disease cannot be suppressed, the doctors use the biologics. The first preparation of this type – infliximab – blocks the tumor necrosis factor (TNF), which is the main driver of the inflammatory process. There are now four more TNF inhibitors on the market. Newer biologicals interfere with the overly responsive defense cells or specifically block other inflammatory messengers, so-called interleukins.

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