Rheumatoid arthritis in Latin America: pharmacotherapy and clinical challenges.

Rheumatoid arthritis (RA) presents significant healthcare challenges in Latin America (LA) due to its high prevalence and unique healthcare dynamics. Despite global advancements, LA faces specific hurdles in managing RA effectively. This manuscript reviews the epidemiology, pharmacotherapies, and clinical challenges of RA in LA. RA prevalence varies, with higher rates in indigenous populations. Treatment guidelines recommend conventional disease-modifying antirheumatic drugs (csDMARDs) as first-line therapy, but access is inconsistent. Biologics, and targeted synthetic DMARDs, are available in most LA countries, though biosimilars are less accessible, with significant variations in drug prices. Barriers to treatment include supply interruptions, diagnosis delays, and high non-adherence rates linked to socioeconomic factors. The severe shortage of rheumatologists, especially in rural areas, impacts patient outcomes. Cardiovascular events and, other comorbidities and endemic infections, further complicate RA management in LA. LA has seen improvements in RA management with better use of csDMARDs, treat-to-target strategies, and advanced treatments. However, challenges remain, including the shortage of rheumatologists, limited continuous medical education, endemic infections, and fragmented healthcare systems. Addressing these issues requires expanding training programs, leveraging telemedicine, and ensuring consistent drug supply. Enhancing clinical research and local data information and improving access to affordable treatments are crucial for better patient outcomes. Comprehensive, region-specific strategies are needed to bridge the gap between LA and more developed regions in RA care.