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Nadir Hastalıklarda Tedaviye Erişim: Mevcut Durum, Engeller ve Çözüm Önerileri

Yıl 2025, Cilt: 15 Sayı: 3, 509 - 514, 24.09.2025
https://doi.org/10.33631/sabd.1507046

Öz

Nadir hastalıkların çoğunda bilimsel ve tıbbi literatürdeki bilgi eksikliği nedeniyle mevcut tedavi seçenekleri yetersiz kalmaktadır. Bu derleme makalesi, nadir hastalıklarda tedaviye erişim konusundaki mevcut durumu, karşılaşılan engelleri ve çözüm önerilerini inceleyerek, sağlık politikası yapıcıları, sağlık profesyonelleri ve ilgili paydaşlar için kaynak sunmayı amaçlamaktadır. Mevcut durum incelendiğinde, nadir hastalıklarla ilgili tanı ve tedavi süreçlerinin uzun ve karmaşık olduğu görülmektedir. Bu süreçler, hastaların doğru tanıya ulaşması ve etkili tedavi alması açısından önemli zorluklar doğurabilir. Ayrıca, nadir hastalıklarda bilimsel ve tıbbi literatürdeki bilgi eksikliği, mevcut tedavi seçeneklerinin sınırlı olmasına yol açarak tedaviye erişimi daha da zorlaştırmaktadır. Engeller arasında, yüksek maliyetli ilaçlar, klinik denemelerin azlığı ve sağlık sistemlerindeki yapısal zorluklar bulunmaktadır. Çözüm önerileri kapsamında ise, nadir hastalıkların tanı ve tedavi süreçlerinin iyileştirilmesi, araştırma ve geliştirme faaliyetlerinin desteklenmesi, sağlık politikalarının güçlendirilmesi ve uluslararası iş birliğinin artırılması gibi stratejiler ön plana çıkmaktadır. Sonuç olarak, nadir hastalıklarda tedaviye erişimdeki mevcut durumun anlaşılması ve çözüm odaklı yaklaşımların benimsenmesi, sağlık politikası yapıcıları, sağlık profesyonelleri ve ilgili paydaşlar için önemli bir gerekliliktir.

Kaynakça

  • Nadirhastalıklaragı.org [İnternet]. Nadir Hastalıklar Ağı. Nadir hastalık nedir? 2024; [cited: 2024 Mar 30]. available from: https://www.nadirhastaliklaragi.org.tr/nadir-hastalik-nedir
  • Pahssc.org [İnternet]. Ankara: Nadir Hastalıklar Sağlık Strateji Belgesi ve Eylem Planı. 2023. Yayın No: 1252. 2024 [cited: 2024 Mar 30]. Available from: https://www.pahssc.org.tr/uploads/nadir-hastaliklar-eylem-plani-webpdf.pdf
  • Tambuyzer E, Vandendriessche B, Austin CP, Brooks PJ, Larsson K, Valentine J, et al. Therapies for rare diseases: therapeutic modalities, progress and challenges ahead. Nature Reviews Drug Discovery. 2020;19(2):93-111.
  • Villalón-García I, Álvarez-Córdoba M, Suárez-Rivero JM, Povea-Cabello S, Talaverón-Rey M, Suárez-Carrillo A, et al. Precision Medicine in Rare Diseases. Diseases. 2020;8(4):42.
  • Pierzynowska K, Kamińska T, Węgrzyn G. One drug to treat many diseases: unlocking the economic trap of rare diseases. Metab Brain Dis. 2020;35(8):1237-40.
  • Cai X, Yang H, Genchev GZ, Lu H, Yu G. Analysis of economic burden and its associated factors of twenty-three rare diseases in Shanghai. Orphanet J Rare Dis. 2019;14(1):233.
  • Lanar S, Acquadro C, Seaton J, Savre I, Arnould B. To what degree are orphan drugs patient-centered? A review of the current state of clinical research in rare diseases. Orphanet J Rare Dis. 2020;15(1):134.
  • Awada N. No decision about us without us: informing rare disease policies in canada with the lived experiences of patients and families with rare genetic lysosomal storage diseases. [PhD dissertation]. Ottawa: Carleton University; 2022.
  • Michaels-Igbokwe C, McInnes B, MacDonald KV, Currie GR, Omar F, Shewchuk B, et al. (Un)standardized testing: the diagnostic odyssey of children with rare genetic disorders in Alberta, Canada. Genet Med. 2021;23:272-9.
  • Zurynski Y, Deverell M, Dalkeith T, Johnson S, Christodoulou J, Leonard H, et al. Australian children living with rare diseases: experiences of diagnosis and perceived consequences of diagnostic delays. Orphanet J Rare Dis. 2017;12(1):68.
  • Orpha.net. [Internet]. Knowlodge on rare diseases and orphan drugs. 2024 [cited: 2024 Mar 30] Available from: https://www.orpha.net/en/other-information/about-orphan-drugs
  • Fermaglich LJ, Miller KL. A comprehensive study of the rare diseases and conditions targeted by orphan drug designations and approvals over the forty years of the Orphan Drug Act. Orphanet J Rare Dis. 2023;18(1):163.
  • Richter T, Nestler-Parr S, Babela R, Khan ZM, Tesoro, T, Molsen E, et al. Rare disease terminology and definitions-a systematic global review: report of the ispor rare disease special ınterest group. Value Health. 2015;18(6):906-14.
  • Blin O, Lefebvre MN, Rascol O, Micallef J. Orphan drug clinical development. Therapie. 2020;75(2):141-7.
  • Koçkaya G, Oguzhan G, Ökçün S, Kurnaz M. Out-of-pocket healthcare expenditures of Turkish households living with rare diseases. Front Public Health. 2023;11:1051851.
  • Kanburoğlu Ç, Kanburoğlu MK. How to teach medical students and clinicians to handle zebras? a holistic algorithm to manage rare diseases. Turk J Pediatr Dis. 2021;1-4.
  • Czech M, Baran-Kooiker A, Atikeler K, Demirtshyan M, Gaitova K, Holownia-Voloskova M, et al. A review of rare disease policies and orphan drug reimbursement systems in 12 eurasian countries. Front Public Health. 2020;7:416.
  • Bogart K, Hemmesch A, Barnes E, Blissenbach T, Beisang A, Engel P, et al. Healthcare access, satisfaction, and health-related quality of life among children and adults with rare diseases. Orphanet J Rare Dis. 2022;17(1):196.
  • Yang J, Dong C, Duan H, Shu Q, Li H. RDmap: a map for exploring rare diseases. Orphanet J Rare Dis. 2021;16(1):101.
  • Marwaha S, Knowles JW, Ashley EA. A guide for the diagnosis of rare and undiagnosed disease: beyond the exome. Genome Med. 2022;14(1):23.
  • Bryson B, Bogart K, Atwood M, Fraser K, Locke T, Pugh K, et al. Navigating the unknown: a content analysis of the unique challenges faced by adults with rare diseases. J Health Psychol. 2021;26(5):623-35.
  • Depping MK, Uhlenbusch N, von Kodolitsch Y, Klose HFE, Mautner VF, Löwe B. Supportive care needs of patients with rare chronic diseases: multi-method, cross-sectional study. Orphanet J Rare Dis. 2021;16(1):44.
  • Pak Güre, Pak C. Nadir hastalığı olan çocukların ailelerinde bakım yükünün incelenmesi. Turk J Fam Med Prim Care. 2021;15(2):269-77.
  • Vandeborne L, Van Overbeeke E, Dooms M, De Beleyr B, Huys I. Information needs of physicians regarding the diagnosis of rare diseases: a questionnaire-based study in Belgium. Orphanet J Rare Dis. 2019;14(1):99.
  • Domaradzki J, Walkowiak D. Knowledge and attitudes of future healthcare professionals toward rare diseases. Front Genet. 2021;12:639610.
  • Kühne A, Kleinheinz J, Jackowski J, Köppe J, Hanisch, M. Study to investigate the knowledge of rare diseases among dentists, orthodontists, periodontists, oral surgeons and craniomaxillofacial surgeons. Int J Environ Res Public Health. 2020;18(1):139.
  • Rarediseases.org. [Internet]. National Organization for Rare Diseases. European Organization for Rare Diseases. Genetic Alliance. Global Genes. 2024 [cited: 2024 Mar 30]. Available from: https://rarediseases.org/
  • Tambuyzer E, Vandendriessche B, Austin CP, Brooks PJ, Larsson K, Miller Needleman KI, et al. Therapies for rare diseases: therapeutic modalities, progress and challenges ahead. Nat Rev Drug Discov. 2020;19(2):93-111.
  • Chen Z, Liu X, Hogan W, Shenkman E, Bian J. Applications of artificial intelligence in drug development using real-world data. Drug Discov Today. 2021;26(5):1256-64.
  • Gupta R, Srivastava D, Sahu M, Tiwari S, Ambasta RK, Kumar P. Artificial intelligence to deep learning: machine intelligence approach for drug discovery. Mol Divers. 2021;25(3):1315-60.
  • Issa NT, Stathias V, Schürer S, Dakshanamurthy S. Machine and deep learning approaches for cancer drug repurposing. Semin Cancer Biol. 2021;68:132-42.
  • Haendel M, Vasilevsky N, Unni D, Bologa C, Harris N, Rehm H, et al. How many rare diseases are there? Nat Rev Drug Discov. 2020;19(2):77-8.
  • Van den Berg S, De Visser S, Leufkens HGM, Hollak, CEM. Drug repurposing for rare diseases: a role for academia. Front Pharmacol. 2021;12:746987.
  • Roessler HI, Knoers NVAM, van Haelst MM, van Haaften G. Drug repurposing for rare diseases. Trends Pharmacol Sci. 2021;42(4):255-67.
  • Kerr K, McAneney H, Smyth LJ, Bailie C, McKee S, McKnight AJ. A scoping review and proposed workflow for multi-omic rare disease research. Orphanet J Rare Dis. 2020;15(1):107.
  • Kumar Y, Koul A, Singla R, Ijaz MF. Artificial intelligence in disease diagnosis: a systematic literature review, synthesizing framework and future research agenda. J Ambient Intell Humaniz Comput. 2023;14(7):8459-86.
  • Roman-Naranjo P, Parra-Perez AM, Lopez-Escamez J.A. A systematic review on machine learning approaches in the diagnosis and prognosis of rare genetic diseases. J Biomed Inform. 2023;143:104429.
  • Li Q, Zhao K, Bustamante CD, Ma X, Wong WH. Xrare: a machine learning method jointly modeling phenotypes and genetic evidence for rare disease diagnosis. Genet Med. 2019;21(9):2126-34.
  • Taruscio D, Salvatore M, Lumaka A, Carta C, Cellai LL, Ferrari G, et al. Undiagnosed diseases: needs and opportunities in 20 countries participating in the undiagnosed diseases network ınternational. Front Public Health. 2023;11:1079601.

Access to Treatment for Rare Diseases: Current Situation, Barriers and Solutions

Yıl 2025, Cilt: 15 Sayı: 3, 509 - 514, 24.09.2025
https://doi.org/10.33631/sabd.1507046

Öz

For most rare diseases, current treatment options are inadequate due to the lack of information in the scientific and medical literature. This review article aims to provide a resource for health policymakers, healthcare professionals and relevant stakeholders by analysing the current situation, barriers, and solutions for access to rare disease treatment. This study is a review of the existing literature on the current situation in access to treatment for rare diseases, barriers, and solutions, and presents a comprehensive assessment of the current situation in access to treatment for rare diseases. These processes can pose significant challenges for patients to reach the correct diagnosis, and receive effective treatment. Furthermore, the lack of information in the scientific and medical literature on rare diseases leads to limited treatment options available, making access to treatment even more difficult. Barriers include high-cost medicines, lack of clinical trials, and structural challenges in health systems. As for solutions, strategies such as improving the diagnosis, and treatment of rare diseases, supporting research, and development activities, strengthening health policies, and increasing international cooperation come to the fore: In conclusion, understanding the current situation in access to treatment for rare diseases and adopting solution-oriented approaches is an important requirement for health policymakers, health professionals, and relevant stakeholders.

Kaynakça

  • Nadirhastalıklaragı.org [İnternet]. Nadir Hastalıklar Ağı. Nadir hastalık nedir? 2024; [cited: 2024 Mar 30]. available from: https://www.nadirhastaliklaragi.org.tr/nadir-hastalik-nedir
  • Pahssc.org [İnternet]. Ankara: Nadir Hastalıklar Sağlık Strateji Belgesi ve Eylem Planı. 2023. Yayın No: 1252. 2024 [cited: 2024 Mar 30]. Available from: https://www.pahssc.org.tr/uploads/nadir-hastaliklar-eylem-plani-webpdf.pdf
  • Tambuyzer E, Vandendriessche B, Austin CP, Brooks PJ, Larsson K, Valentine J, et al. Therapies for rare diseases: therapeutic modalities, progress and challenges ahead. Nature Reviews Drug Discovery. 2020;19(2):93-111.
  • Villalón-García I, Álvarez-Córdoba M, Suárez-Rivero JM, Povea-Cabello S, Talaverón-Rey M, Suárez-Carrillo A, et al. Precision Medicine in Rare Diseases. Diseases. 2020;8(4):42.
  • Pierzynowska K, Kamińska T, Węgrzyn G. One drug to treat many diseases: unlocking the economic trap of rare diseases. Metab Brain Dis. 2020;35(8):1237-40.
  • Cai X, Yang H, Genchev GZ, Lu H, Yu G. Analysis of economic burden and its associated factors of twenty-three rare diseases in Shanghai. Orphanet J Rare Dis. 2019;14(1):233.
  • Lanar S, Acquadro C, Seaton J, Savre I, Arnould B. To what degree are orphan drugs patient-centered? A review of the current state of clinical research in rare diseases. Orphanet J Rare Dis. 2020;15(1):134.
  • Awada N. No decision about us without us: informing rare disease policies in canada with the lived experiences of patients and families with rare genetic lysosomal storage diseases. [PhD dissertation]. Ottawa: Carleton University; 2022.
  • Michaels-Igbokwe C, McInnes B, MacDonald KV, Currie GR, Omar F, Shewchuk B, et al. (Un)standardized testing: the diagnostic odyssey of children with rare genetic disorders in Alberta, Canada. Genet Med. 2021;23:272-9.
  • Zurynski Y, Deverell M, Dalkeith T, Johnson S, Christodoulou J, Leonard H, et al. Australian children living with rare diseases: experiences of diagnosis and perceived consequences of diagnostic delays. Orphanet J Rare Dis. 2017;12(1):68.
  • Orpha.net. [Internet]. Knowlodge on rare diseases and orphan drugs. 2024 [cited: 2024 Mar 30] Available from: https://www.orpha.net/en/other-information/about-orphan-drugs
  • Fermaglich LJ, Miller KL. A comprehensive study of the rare diseases and conditions targeted by orphan drug designations and approvals over the forty years of the Orphan Drug Act. Orphanet J Rare Dis. 2023;18(1):163.
  • Richter T, Nestler-Parr S, Babela R, Khan ZM, Tesoro, T, Molsen E, et al. Rare disease terminology and definitions-a systematic global review: report of the ispor rare disease special ınterest group. Value Health. 2015;18(6):906-14.
  • Blin O, Lefebvre MN, Rascol O, Micallef J. Orphan drug clinical development. Therapie. 2020;75(2):141-7.
  • Koçkaya G, Oguzhan G, Ökçün S, Kurnaz M. Out-of-pocket healthcare expenditures of Turkish households living with rare diseases. Front Public Health. 2023;11:1051851.
  • Kanburoğlu Ç, Kanburoğlu MK. How to teach medical students and clinicians to handle zebras? a holistic algorithm to manage rare diseases. Turk J Pediatr Dis. 2021;1-4.
  • Czech M, Baran-Kooiker A, Atikeler K, Demirtshyan M, Gaitova K, Holownia-Voloskova M, et al. A review of rare disease policies and orphan drug reimbursement systems in 12 eurasian countries. Front Public Health. 2020;7:416.
  • Bogart K, Hemmesch A, Barnes E, Blissenbach T, Beisang A, Engel P, et al. Healthcare access, satisfaction, and health-related quality of life among children and adults with rare diseases. Orphanet J Rare Dis. 2022;17(1):196.
  • Yang J, Dong C, Duan H, Shu Q, Li H. RDmap: a map for exploring rare diseases. Orphanet J Rare Dis. 2021;16(1):101.
  • Marwaha S, Knowles JW, Ashley EA. A guide for the diagnosis of rare and undiagnosed disease: beyond the exome. Genome Med. 2022;14(1):23.
  • Bryson B, Bogart K, Atwood M, Fraser K, Locke T, Pugh K, et al. Navigating the unknown: a content analysis of the unique challenges faced by adults with rare diseases. J Health Psychol. 2021;26(5):623-35.
  • Depping MK, Uhlenbusch N, von Kodolitsch Y, Klose HFE, Mautner VF, Löwe B. Supportive care needs of patients with rare chronic diseases: multi-method, cross-sectional study. Orphanet J Rare Dis. 2021;16(1):44.
  • Pak Güre, Pak C. Nadir hastalığı olan çocukların ailelerinde bakım yükünün incelenmesi. Turk J Fam Med Prim Care. 2021;15(2):269-77.
  • Vandeborne L, Van Overbeeke E, Dooms M, De Beleyr B, Huys I. Information needs of physicians regarding the diagnosis of rare diseases: a questionnaire-based study in Belgium. Orphanet J Rare Dis. 2019;14(1):99.
  • Domaradzki J, Walkowiak D. Knowledge and attitudes of future healthcare professionals toward rare diseases. Front Genet. 2021;12:639610.
  • Kühne A, Kleinheinz J, Jackowski J, Köppe J, Hanisch, M. Study to investigate the knowledge of rare diseases among dentists, orthodontists, periodontists, oral surgeons and craniomaxillofacial surgeons. Int J Environ Res Public Health. 2020;18(1):139.
  • Rarediseases.org. [Internet]. National Organization for Rare Diseases. European Organization for Rare Diseases. Genetic Alliance. Global Genes. 2024 [cited: 2024 Mar 30]. Available from: https://rarediseases.org/
  • Tambuyzer E, Vandendriessche B, Austin CP, Brooks PJ, Larsson K, Miller Needleman KI, et al. Therapies for rare diseases: therapeutic modalities, progress and challenges ahead. Nat Rev Drug Discov. 2020;19(2):93-111.
  • Chen Z, Liu X, Hogan W, Shenkman E, Bian J. Applications of artificial intelligence in drug development using real-world data. Drug Discov Today. 2021;26(5):1256-64.
  • Gupta R, Srivastava D, Sahu M, Tiwari S, Ambasta RK, Kumar P. Artificial intelligence to deep learning: machine intelligence approach for drug discovery. Mol Divers. 2021;25(3):1315-60.
  • Issa NT, Stathias V, Schürer S, Dakshanamurthy S. Machine and deep learning approaches for cancer drug repurposing. Semin Cancer Biol. 2021;68:132-42.
  • Haendel M, Vasilevsky N, Unni D, Bologa C, Harris N, Rehm H, et al. How many rare diseases are there? Nat Rev Drug Discov. 2020;19(2):77-8.
  • Van den Berg S, De Visser S, Leufkens HGM, Hollak, CEM. Drug repurposing for rare diseases: a role for academia. Front Pharmacol. 2021;12:746987.
  • Roessler HI, Knoers NVAM, van Haelst MM, van Haaften G. Drug repurposing for rare diseases. Trends Pharmacol Sci. 2021;42(4):255-67.
  • Kerr K, McAneney H, Smyth LJ, Bailie C, McKee S, McKnight AJ. A scoping review and proposed workflow for multi-omic rare disease research. Orphanet J Rare Dis. 2020;15(1):107.
  • Kumar Y, Koul A, Singla R, Ijaz MF. Artificial intelligence in disease diagnosis: a systematic literature review, synthesizing framework and future research agenda. J Ambient Intell Humaniz Comput. 2023;14(7):8459-86.
  • Roman-Naranjo P, Parra-Perez AM, Lopez-Escamez J.A. A systematic review on machine learning approaches in the diagnosis and prognosis of rare genetic diseases. J Biomed Inform. 2023;143:104429.
  • Li Q, Zhao K, Bustamante CD, Ma X, Wong WH. Xrare: a machine learning method jointly modeling phenotypes and genetic evidence for rare disease diagnosis. Genet Med. 2019;21(9):2126-34.
  • Taruscio D, Salvatore M, Lumaka A, Carta C, Cellai LL, Ferrari G, et al. Undiagnosed diseases: needs and opportunities in 20 countries participating in the undiagnosed diseases network ınternational. Front Public Health. 2023;11:1079601.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Münire Yıldırım 0009-0006-0940-6455

Hülya Keskin 0000-0003-3897-0814

Yayımlanma Tarihi 24 Eylül 2025
Gönderilme Tarihi 29 Haziran 2024
Kabul Tarihi 19 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 15 Sayı: 3

Kaynak Göster

Vancouver Yıldırım M, Keskin H. Nadir Hastalıklarda Tedaviye Erişim: Mevcut Durum, Engeller ve Çözüm Önerileri. SABD. 2025;15(3):509-14.