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Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases

For many years, inflammatory rheumatic diseases (IRDs) represented a source of disappointment in medical care caused by the mediocre efficacy of the available treatments. Some of these diseases, like Rheumatoid Arthritis (RA) or Ankylosing Spondylitis (AS), caused fear in the general population, esp...

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Autores principales: Berghea, Florian, Berghea, Camelia Elena, Zaharia, Dumitru, Trandafir, Andreea Iulia, Nita, Elena Cristina, Vlad, Violeta Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415826/
https://www.ncbi.nlm.nih.gov/pubmed/34485342
http://dx.doi.org/10.3389/fmed.2021.712645
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author Berghea, Florian
Berghea, Camelia Elena
Zaharia, Dumitru
Trandafir, Andreea Iulia
Nita, Elena Cristina
Vlad, Violeta Maria
author_facet Berghea, Florian
Berghea, Camelia Elena
Zaharia, Dumitru
Trandafir, Andreea Iulia
Nita, Elena Cristina
Vlad, Violeta Maria
author_sort Berghea, Florian
collection PubMed
description For many years, inflammatory rheumatic diseases (IRDs) represented a source of disappointment in medical care caused by the mediocre efficacy of the available treatments. Some of these diseases, like Rheumatoid Arthritis (RA) or Ankylosing Spondylitis (AS), caused fear in the general population, especially due to associated joint deformities and subsequent disabilities. However, in the last 20 years, a new successful class of antirheumatic drugs has become available: biologic Disease-Modifying Antirheumatic Drugs (bDMARDs). Due to this innovative treatment, the days are over when joint and spine deformities defined the condition of a person with RA or AS. Nonetheless, expectations are higher today, and other clinical problems, (not entirely solved by bDMARDs), seem to drive the drug selection during the span of rheumatic diseases. Most of these issues are covered by the term “unmet needs.” One of the most intriguing of such needs is the residual pain (RP) in patients that are otherwise in the biological remission of the disease. Present in a significant proportion of the patients that enter remission status, RP is poorly understood and managed. In recent years, new data has become available in this area and new conceptual clarifications have occurred. In this review, we explain the various nature of RP and the necessity of treatment diversification in such situations. All in all, we believe this condition is far more complex than simple pain and includes other clinical aspects, too (like fatigue or mood changes) so the terms Post-Remission Syndrome (PRS), and PRS pain might be more appropriate.
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spelling pubmed-84158262021-09-04 Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases Berghea, Florian Berghea, Camelia Elena Zaharia, Dumitru Trandafir, Andreea Iulia Nita, Elena Cristina Vlad, Violeta Maria Front Med (Lausanne) Medicine For many years, inflammatory rheumatic diseases (IRDs) represented a source of disappointment in medical care caused by the mediocre efficacy of the available treatments. Some of these diseases, like Rheumatoid Arthritis (RA) or Ankylosing Spondylitis (AS), caused fear in the general population, especially due to associated joint deformities and subsequent disabilities. However, in the last 20 years, a new successful class of antirheumatic drugs has become available: biologic Disease-Modifying Antirheumatic Drugs (bDMARDs). Due to this innovative treatment, the days are over when joint and spine deformities defined the condition of a person with RA or AS. Nonetheless, expectations are higher today, and other clinical problems, (not entirely solved by bDMARDs), seem to drive the drug selection during the span of rheumatic diseases. Most of these issues are covered by the term “unmet needs.” One of the most intriguing of such needs is the residual pain (RP) in patients that are otherwise in the biological remission of the disease. Present in a significant proportion of the patients that enter remission status, RP is poorly understood and managed. In recent years, new data has become available in this area and new conceptual clarifications have occurred. In this review, we explain the various nature of RP and the necessity of treatment diversification in such situations. All in all, we believe this condition is far more complex than simple pain and includes other clinical aspects, too (like fatigue or mood changes) so the terms Post-Remission Syndrome (PRS), and PRS pain might be more appropriate. Frontiers Media S.A. 2021-08-17 /pmc/articles/PMC8415826/ /pubmed/34485342 http://dx.doi.org/10.3389/fmed.2021.712645 Text en Copyright © 2021 Berghea, Berghea, Zaharia, Trandafir, Nita and Vlad. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Berghea, Florian
Berghea, Camelia Elena
Zaharia, Dumitru
Trandafir, Andreea Iulia
Nita, Elena Cristina
Vlad, Violeta Maria
Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title_full Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title_fullStr Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title_full_unstemmed Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title_short Residual Pain in the Context of Selecting and Switching Biologic Therapy in Inflammatory Rheumatic Diseases
title_sort residual pain in the context of selecting and switching biologic therapy in inflammatory rheumatic diseases
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415826/
https://www.ncbi.nlm.nih.gov/pubmed/34485342
http://dx.doi.org/10.3389/fmed.2021.712645
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