Pourquoi et comment organiser le dépistage et la prévention des complications des rhumatismes inflammatoires chroniques : Intérêt des revues systématiques initiales et périodiques

Abstract

Patients suffering from chronic inflammatory rheumatic diseases (whether rheumatoid arthritis, spondyloarthritis, connective tissue disease but also microcrystalline arthropathy or even polyarthrosis) should be able to benefit from standardized holistic care as soon as the diagnosis of chronic inflammatory rheumatic disease is done then periodically. This management (also called « systematic review ») must include a) an ov erall assessment of the disease (certainty of the diagnosis, activity, severity, potential severity and finally the notion of refractory disease or not) b) learning a self-assessment disease activity via composite indices such as the DAS-28 for rheumatoid arthritis or the ASDAS for spondyloarthritis c) an assessment of adherence to treatment d) prevention of the main comorbidities e) information/education about the disease and its treatments f) information about the different areas that could impact the patient's life (diet, sexuality, pregnancy, social care, etc..). Although our health authorities have put in place the means to support these systematic reviews, it is necessary that the treating rheumatologists are convinced of their interest to ensure their success.