Hub therapy as a new opportunity for treatment of comorbid diseases

In this review we discuss literature data and our own findings regarding treatment of syntropic comorbid diseases. We propose a pathogenetic rationale for the use of drugs targeting central intermolecular hubs linking inflammation, lipid homeostasis, and immune responses in patients with several autoimmune disorders complicated by accelerated atherosclerosis. We provide examples of successful and safe use of PPARa agonist fenofibrate and HMG CoA inhibitor simvastatin in patients with rheumatoid arthritis, osteoarthritis, and psoriasis. Anti-inflammatory action of these drugs was accompanied by lipid-modulating and immune modulating effects. Data on selective inhibition of NF-κB in several autoimmune disorders associated with comorbidities are reviewed. We also analyzed literature data on the use of a phosphodiesterase 4 inhibitor roflumilast in COPD-associated comorbid diseases. In conclusion, the use of drugs directed at intermolecular hub targets is a promising and pathogenetically based approach to the treatment of syntropic comorbid diseases.