There are many capable young Saudi doctors here who can be trained to be expert rheumatologists if they just receive the proper training and professional preparation, said Prof. Josef Smolen, the chairman of rheumatology department at the Medical University of Vienna, who was here to attend the recently concluded 10th Pan Arab Rheumatology Conference (PARC 2012). “I noticed (during the conference) that the audience was very educated about rheumatology diseases and the questions raised during the workshops and sessions were very clever and specific,” he told the Saudi Gazette on the sidelines of the conference. To a question on the latest development in the treatments of rheumatology diseases specifically the RA and the most up-to-date biologic medications, Prof. Smolen said that biological medicines were a new group of drugs that have been in use for 10 years and are produced from modern DNA-based methods. Such a treatment is called target-therapy which is exclusively designed to target a specific goal, which makes them more effective and reduces the risk of adverse reaction. The biologic therapy – for example Actemra — involves blocking the action of specific proteins of inflammation, called tumor necrosis factor (TNF). This is being used for the treatment of a number of diseases, including rheumatoid arthritis and other diseases. These drugs can only be injected and are complicated to produce, which means that the cost of a drug for one patient is very expensive. Biological medicines have revolutionized rheumatologic therapy, but there are still some concerns, as the long-term effects are not fully understood. He said that the early recognition and diagnosis of the case before it develops to a more advance stage would help much more in controlling the disease than the use of traditional medications. In addition to this, new rheumatoid arthritis classification criteria were introduced in 2010 by the American College of Rheumatology (ACR) which overruled the old ACR of 1987 and this has contributed a lot to the early diagnosis of RA. To a question of whether effective medicines are available at more reasonable prices than biological drugs, he said that there are – what he called – similar biological medicinal products or “Biosimilars.” This is a new and cheaper tailor-made way of targeting medicines with the medication made from the production of recombinant DNA or “molecular cloning” which can bring genetic materials from multiple sources. Biolsimilars have been produced lately by some pharmaceutical companies in India and China and they are far more affordable than the proto-type biological medicines for RA. __
