Gastroduodenal safety of Nimesulid (Nimesil, Berlin Chemie) in rheumatic patients with history of ulcer

Objective. To assess safety of nimesulid in rheumatic pts with history of ulcer or multiple erosions (ME) of stomach and/or duodenal mucosa. Methods. 42 pts with rheumatic diseases aged 22-73 years were included. AH had gastric or duodenal ulcers or ME (n>10) connected with NSAID treatment and confirmed by endoscopy no more than 6 months before the beginning of the study. Pts were included after healing of ulcers and erosions. The pts were randomized to receive Nimesulid 200 mg/day (group 1) or Diclofenac suppositoria 100 mg/day + ranitidine 150 mg/day (group 2). Esophagogastroduodenoscopy was performed before and 12 weeks after the beginning of treatment. Results. Relapse of stomach ulcer was observed in I pts of group 1 (5,6%). Relapse of NSAID-induced ulcers and ME was noted in 6 pts of group 2 (33,3%): in 4 cases stomach ulcers, in 1 case stomach ME, in 1 case duodenal ulcer (p=0,0424). Presence of gastralgias and dyspepsia was noted in 36,8% pts of group 1 and in 20% pts of group 2 (p=0,0539). In 1 pts of group 2 gastralgias were the reason for premature endoscopy. Conclusion. Nimesil (Nimesulid) can be considered as a more safe drug than classical NSAIDs with smaller risk of serious gastroduodenal complications development in rheumatic pts with ulcer history. The results of the study allow to recommend Nimesulid as a drug of choice for treatment of pts with history of NSAID-induced gastropathy

New approaches to the assessment of rheumatoid arthritis activity: Simplified Disease Activity Index (SDAI) TOC \o "1-5" \h \z in early arthritis

Objective. To assess significance of Simplified Disease Activity Index (SDAI) in early arthritis. Material and methods . 76 pts with suspicion of rheumatoid arthritis (RA), duration of the disease less than 6 months (3,6±1,7 months), meanage48,5±14years(17-76years)and male/female ratio 1/5 were examined. DAS 28 and SDAI were calculated for complex assessment of arthritis activity. Results. Mean SDAI value was 28,9±14,9 (1,37-67,64). In 40 (52,1%) of pts it corresponded to moderate, in 20 (26,6%) - to low and in 16 (21,3%) - to high activity of RA. Mean DAS 28 value was 4,86+1,23 (2,31-6,92). 12,5% of pts had low, 40,3% - moderate and 47,2% - high activity. SDAI significantly correlated with DAS 28 (p<0,0001). Functional status examination showed mean HAQ value 0,82±0,62(0-2,5). HAQ correlated with SDAI and DAS 28 (p<0,005). In 37 from 76 pts (48,7%) RA was diagnosed according to ACR 1987 criteria. In 39 (51,3%) of pts the diagnosis was not verified and they were considered as having undifferentiated arthritis (UDA). SDAI values in RA were significantly higher than in UDA (33,1±I5,9 and 24,5+12,3 respectively, p<0,05). Similar differences were shown for DAS 28 (4,72±1,1 in RAand 2,9±0,7 in UDA, p<0,05. 30,8% of RA pts had low, 48,7% - moderate and 20,5% - high inflammatory activity according to SDAI. In UDA low and moderate activity were more frequent (59,5% and 32,4% respectively) than in RA. DAS 28 and SDAI activity stages completely coincided neither in RA nor in UDA pts. Conclusion. SDAI is a sensitive method of activity assessment and correlates with DAS and HAQ not only in definite long standing RA that was shown at validation of this index but also in early arthritis

Study of correlation between bone mineral density and clinical and laboratory indices of rheumatoid arthritis activity

Objective. To study association between bone mineral density (BMD) and clinical and laboratory indices of rheumatoid arthritis (RA) activity Material and methods. 60 women with RA who had not received glucocorticoid and anti-osteoporotic therapy were included. 30 had unchanged menstrual cycle and 30 were postmenopausal. Lumbar spine BMD and proximal femur was studied with double radiological absorptiometry (QDR 1000 Hologic apparatus). W.Wilke indices were used to characterize activity and severity of RA. CRP level was evaluated with quantitative immunoenzyme method. Results. Significant negative association was revealed between spine and femoral neck BMD and RA severity so as between femoral neck BMD and CRP level in pts with unchanged menstrual cycle and in postmenopausal pts

Stimulated Cellular Immune System in Patients with Congestive Heart Failure

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