Rheumatology Section, Hospital Italiano de Buenos Aires and University Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Organizacion Medica de Investigación, Buenos Aires, Argentina.
Expert Opin Pharmacother. 2024 Oct;25(15):2023-2033. doi: 10.1080/14656566.2024.2412247. Epub 2024 Oct 10.
Rheumatoid arthritis (RA) poses significant healthcare challenges in Latin America (LA) due to its high prevalence and unique healthcare dynamics. Despite global advancements, LA faces specific hurdles in effectively managing RA.
This review examines RA epidemiology, treatment strategies, and clinical challenges in LA. RA prevalence varies, with higher rates among indigenous populations. While conventional disease-modifying antirheumatic drugs (csDMARDs) are recommended as first-line therapy, access remains inconsistent. Biologics and targeted synthetic DMARDs are available, but biosimilars have limited accessibility, with drug prices varying significantly. Key barriers include supply interruptions, diagnosis delays, and high non-adherence rates driven by socioeconomic factors. A severe shortage of rheumatologists, particularly in rural areas, affects patient care. Cardiovascular events, comorbidities, and endemic infections further complicate RA management.
Although RA care in LA has improved through better use of csDMARDs and advanced treatments, major challenges persist, such as a shortage of specialists, limited medical education, and fragmented healthcare systems. Expanding training programs, enhancing telemedicine, and ensuring drug supply continuity are essential. Strengthening clinical research, improving access to affordable treatments, and developing comprehensive, region-specific strategies are crucial to closing the gap between LA and more developed regions in RA care..
类风湿关节炎（RA）在拉丁美洲（LA）由于其高患病率和独特的医疗保健动态，带来了重大的医疗保健挑战。尽管全球取得了进展，但 LA 在有效管理 RA 方面仍面临着特定的障碍。
这篇综述考察了 RA 在 LA 的流行病学、治疗策略和临床挑战。RA 的患病率存在差异，土著人群中的发病率较高。虽然传统的疾病修饰抗风湿药物（csDMARDs）被推荐为一线治疗药物，但获得这些药物的机会仍然不一致。生物制剂和靶向合成 DMARDs 是可用的，但生物类似药的可及性有限，药物价格差异很大。关键障碍包括供应中断、诊断延迟以及由社会经济因素驱动的高不遵医率。风湿病学家严重短缺，特别是在农村地区，这影响了患者的护理。心血管事件、合并症和地方性感染进一步使 RA 管理复杂化。
尽管通过更好地使用 csDMARDs 和先进的治疗方法，LA 的 RA 护理有所改善，但仍存在重大挑战，如专科医生短缺、医学教育有限以及医疗保健系统碎片化。扩大培训计划、加强远程医疗以及确保药物供应连续性至关重要。加强临床研究、改善获得负担得起的治疗方法的机会以及制定全面的、针对特定地区的策略对于缩小 LA 和 RA 护理更发达地区之间的差距至关重要。
