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Indian rheumatologists view standalone centres of care to ensure easy access to specialists
Nandita Vijay, Bengaluru | Saturday, October 12, 2013, 08:00 Hrs  [IST]

Healthcare entrepreneurs need to look at setting up dedicated Arthritis hospitals in the wake of an alarming rise in the incidence of this condition. It would allow easy access to qualified rheumatologists who could ensure quick diagnosis, prescribe early treatment to scores of patients and help retard the progression of the disease. India only has around 200 rheumatologists and is reporting a shortfall of 800 specialists, medical experts say.

On the occasion of the World Arthritis Day observed on October 12, 2013, a panel of experts concur that stand alone centres would help offer treatment under one roof. This includes lab tests, consultation, physiotherapy and surgery. It could also lead to a number of medical colleges offering this specialty in country and help offset the growing shortage of experts to treat the condition. Moreover, complete disease-remission could be achieved if the patient comes at an early stage, which could prevent related deformities.

Arthritis is incurable and is a heterogeneous disease where each patient requires a different treatment protocol. There is need to monitor patients closely to help suppress the disease, address the side-effects and to help them remission of pain killers and steroids, points out Dr Raj Kiran Dudam, consultant rheumatologist, Care Hospital, Banjara Hills, Hyderabad.

India currently has more non- rheumatologists treating patients. There is need for a focused team to ensure that once diagnosed, the drug therapy is advised immediately and follows-ups are monitored closely. The big challenge before rheumatologists is to balance proper disease control and prevent drug side effects. A dedicated centre of arthritis care could ensure smooth transition from pain to relief and disease remission besides de-escalation of medication thereafter which is seen possible in many patients, said Dr. Kiran.

The latest treatment protocols are biologicals. But this is administered only if conventional disease-modifying anti-rheumatic drugs fail to respond. A slew of newer disease-modifying biologics like etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), rituximab (Rituxan) and abatacept (Orencia) are available.

According to Dr Manish Dugar, rheumatologist, Apollo Hospitals, Hyderabad, vitamin D deficiency is highly prevalent in patients with RA, and could be linked to the severity of the disease.

It is reported that 15 per cent of India’s population suffer from arthritis. While osteoarthritis is a age-related degenerative disease affecting 60 years, RA affects age-group from 35-50 years. There are also cases of juvenile arthritis which is seen to be a difficult to treat.

The increasing number of patients, poor awareness and the challenge to limit the side-effects of drugs, calls for the need for standalone arthritis hospitals, said Dr Vishnu Sharma, consultant rheumatologist, Shalby Hospital Ahmedabad.

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