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Conquering rheumatoid arthritis. The latest breakthroughs and treatments
  1. E M Veys

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    Thomas Lee is a professor of microbiology and biotechnology and is also a patient with rheumatoid arthritis (RA). He has studied and read about rheumatic diseases, mainly about RA, and felt the need for a comprehensive work to explain to patients with RA more about the mechanism of their disease and current and future treatments. It is not meant for, and offers little new to, the professional reader. On the other hand, it may be too complicated for a patient without a medical background. Those targeted are also clearly American patients: prices are always given in US dollars, references are only to USA regulations and, moreover, the major part of research quoted was done in the USA.

    The author first gives some definitions of rheumatic diseases, followed by chapters about immunology and the mechanisms of disease. A lot of attention is given to genes and their role in RA. Much seems to be expected from the human genome project and from genetic targeted treatments. A chapter is dedicated to bone marrow and stem cell transplantation. Though the author mentions the side effect of these treatments, he still considers them a “miracle”, giving, I fear, undue hope to patients. The next chapter gives a clear overview of the current treatments for RA and is followed by chapters about new treatments, clinical trials, and drugs in the pipeline. At the end useful websites are listed.

    My main criticism is that it is too easy for professionals, but too difficult for patients without a medical background. While some chapters are clear, for instance those about treatments, others, or part of others, seem to be really difficult to understand for lay people. The information given is sometimes anecdotal, for instance, in the chapter about stem cell transplantation where there are no references. Only websites are given as references. These may be easily accessible, but I think classical referencing allows for easier checking of what is stated. Moreover, I fear that false hopes may be raised by describing some treatments that are still far from being used in practice.

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