Mediterr J Rheumatol 2019;30(3);141-6
Twenty Years of Targeted Treatment in Rheumatoid Arthritis in the Greek Databases: Achievements and Unmet Needs
Authors Information
1Department of Rheumatology and Clinical Immunology, School of Medicine, University of Crete, Greece
2First Department of Propaedeutic and Internal Medicine & Rheumatology Unit, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
34th Department of Internal Medicine, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
4nd Department of Medicine and Laboratory, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
5Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
6Laboratory of Rheumatology, Inflammation and Autoimmunity, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology, Heraklion, Greece
7Laboratory of Immune Regulation and Tolerance, Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece

Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects ~1% of the population worldwide, associated with substantial morbidity and mortality. Biologic agents were introduced 20 years ago in Greece, and the management of the disease has paralleled the European experience with early adoption of the EULAR recommendations and the Treat-to-Target-strategy in the local guidelines. Local guidelines are regularly updated to incorporate changes in the treatment algorithms. Following the financial crisis, these were ultimately incorporated into the mandatory electronic prescription therapeutic protocols.  
During the last 20 years, several publications from the country have captured important aspects of the disease from its epidemiology to the clinical use of biologics and management of comorbidities.1-4 In this communication, we review the management of RA and its evolution over time in Greece, discussing the major achievements and the unmet needs of the disease in an effort to put this into a perspective. We conclude that introduction of biologic therapy has revolutionized the treatment of difficult to treat RA in-spite of the multiple unmet needs. While striving for even better outcomes, we cannot lose sight of the major impact of biologic therapies on the lives of patients with RA.