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How to reduce the waiting time for the first consultation with the rheumatologist as a first step for a timely treatment
  1. Omar Valenzuela,
  2. Sebastián E Ibáñez Vodnizza
  1. Facultad de Medicina Clínica Alemana–Universidad del Desarrollo, Hospital Padre Hurtado, Santiago, Chile
  1. Correspondence to Dr Omar Valenzuela, Hospital Padre Hurtado, Facultad de Medicina Clínica Alemana–Universidad del Desarrollo, Santiago, Chile; omarvalen{at}gmail.com

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In Chile, the guaranteed therapy for rheumatoid arthritis did not consider biological drugs until 2015, when Law 20850 was promulgated.1 The criteria to start biological treatment and the follow-up periods differ from validated treat to target (T2T) strategies,2 allowing access only to patients who remain with a disease activity Score-28 with erythrocite sedimentation rate (DAS28-ESR) >5.1 despite 6 months of treatment with three non-biological disease-modifying antirheumatic drugs (DMARDs).3 Our results of the application of this law during the first year were recently published.4

The implementation of this law allowed us to identify difficulties to implement a successful T2T strategy: (1) access to the rheumatologist; (2) impossibility of carrying out an early control because of absence of medical hours; (3) limitation in the therapeutic …

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