Rheumatoid arthritis in Czechia needs faster diagnosis, access to treatment

In Czechia, over 160,000 people and approximately 4,000 children are living with rheumatoid arthritis. While modern medicine offers hope, early diagnosis and better access to treatment remain critical.

A chronic inflammatory disease that affects the joints, rheumatoid arthritis (RA) causes swelling, pain, and stiffness. In the past, RA inevitably led to disability and dependency, but now significant advancements in treatment offer hope.

With the right combination of modern medicines, physiotherapy, and lifestyle changes, patients could lead more independent lives. However, these improvements remain inaccessible to many due to delays in diagnosis and limited access to modern treatments, experts warn.

"Currently, patients can wait several months from the onset of symptoms to see a specialist," explained Ladislav Šenolt, Chairman of the Czech Rheumatology Society.

Delays in diagnosis

According to a recent report from the Czech Association of Innovative Pharmaceutical Industry (AIFP), RA affects thousands of new patients each year, and the number is expected to grow.

By 2040, it is predicted that there will be over 169,000 people living with RA in the country. Most are women between the ages of 40 and 60, but it is a disease that does not spare children either. Approximately 4,000 children in the country have juvenile idiopathic arthritis, with two to three hundred new cases diagnosed each year.

For patients with RA, early diagnosis and prompt treatment are critical to managing the disease effectively. However, Czechia faces significant challenges in this area.

Delays can have severe consequences. "It takes an average of eight years for patients to access biological treatment in Czechia, while in other countries, they receive it two years earlier," said Šenolt during the presentation of the new AIFP report.

Biological treatments have revolutionised the treatment of RA. These advanced medications target specific components of the immune system and have been proven to slow the progression of the disease, reduce inflammation, and prevent joint damage. Despite their effectiveness, only a small fraction of Czech patients have access to these therapies.

"Innovative treatment is provided to just four per cent of patients," emphasised David Kolář, Executive Director of AIFP. This limited access can result in worsened outcomes for many patients who could benefit from earlier intervention.

A shortage of rheumatologists

One of the key factors contributing to the delays in diagnosis and treatment is a nationwide shortage of rheumatologists – there are only 280 rheumatologists across Czechia.

"The shortage of rheumatologists could be partly solved by transferring some competencies to GPs, for example, in monitoring patients," Šenolt suggested.

"Motivating medical students to study rheumatology, which has been intensively supported by our professional society in recent years, should go hand in hand," the Czech leading expert added.

This shortage of specialists, combined with the growing number of RA patients, presents a major challenge for the Czech healthcare system. The demand for rheumatology services is increasing by about five per cent each year, yet there are few signs that the number of trained professionals will increase to meet this demand anytime soon.

Despite these obstacles, there have been notable improvements in RA care in Czechia. In the past, RA often led to full disability and reduced life expectancy by five to ten years. Thanks to modern treatments, many patients can now live relatively normal lives. Biological treatments are available in specialised medical centres, with the majority of patients being treated in Prague.

Pan-European issue

The challenges faced by patients in Czechia are mirrored across Europe. An estimated 120 million Europeans live with rheumatic and musculoskeletal diseases (RMDs), making them one of the most prevalent chronic conditions on the continent. RMDs, which include RA, are often referred to as "invisible diseases" due to the lack of public awareness despite their profound impact on individuals, families, and economies.

At June's European Alliance of Associations for Rheumatology (EULAR) congress in Vienna, experts emphasised the urgent need for a coordinated European response to the growing burden of RMDs.

In its 2024–2029 European Manifesto, EULAR outlines the pressing need for better prevention, earlier diagnosis, and more accessible treatment options. It also calls for more research into the causes of these diseases and the development of innovative treatment models that can be applied across Europe. EULAR is particularly pushing for increased funding for research, more accessible care, and the inclusion of RMDs in national health strategies.

[Edited by Vasiliki Angouridi, Brian Maguire | Euractiv's Advocacy Lab]