Social significance of rheumatic diseases, negative consequences for the health care system and ways of prevention

Background. Immunoinflammatory rheumatic diseases (IIRDs) are a significant medical and social problem leading to high mortality, disability and economic burden for society. These diseases, such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondylitis (axSpA), significantly reduce the quality of life of patients and increase the financial burden on healthcare systems. Objective. The aim of this systematic review is to assess current data on the risk of death in patients with IIRDs and identify factors associated with increased mortality, as well as analyze the effectiveness of biological drugs in reducing this risk. Materials and methods. The review includes data from multiple clinical trials and meta-analyses covering the period from 2000 to 2021. The analysis was based on data collected from various sources, including national registries, clinical trials and meta-analyses. Results. The main results show that IIRDs such as RA, PsA and axSpA significantly increase the risk of death compared to the general population (SMR 2.02 1.79; 2.29). Disease activity, smoking and comorbid conditions are key factors increasing the risk of mortality. The use of biological agents in therapy reduces the risk of death compared to no biological therapy(HR 0.52 0.32; 0.86) and compared to methotrexate (HR 0.77 0.60; 0.97). The use of biological agents also reduces the risk of cardiovascular events and the development of dementia. Conclusions. Early and active use of biological agents can be a significant factor in reducing the negative consequences of IRDs, including mortality and the progression of cardiovascular diseases. Conclusion. The results of the systematic review may be useful for developing strategies for managing IIRDs and optimizing medical care for patients. The introduction of GIBPs into the treatment of IIRDs can significantly improve the prognosis and quality of life of patients, reducing the risk of mortality and other adverse outcomes.