Терапия псориатического артрита инфликсимабом

Objective: to study the efficacy and tolerability of infliximab (Remicade) in the major syndromes of psoriatic arthritis (PA). Subjects and methods. The study was based on Remicade therapy in 22 patients with severe and moderate PA with polyarthritic, osteolytic and spondyloarthritic types of the joint syndrome, generalized psoriasis vulgar and erythrodermata, and pustular psoriasis. Inflammatory activity was determined by DAS 4 and the efficiency of therapy was evaluated by the ACR and EULAR criteria. The severity of psoriasis was judged from the PASI index. Inefficiency or intolerability of essential anti-inflammatory drugs (EAIDs) was observed in all the patients. Therapy with Remicade in combination with methotrexate was performed in 7 patients; the other patients took Remicade without EAIDs. The drug was intravenously injected in a dose of 5 mg/kg by the generally accepted scheme. The efficacy of the first 5 Remicade infusions was evaluated. Results. Just after the first infliximab infusion, there was a significant reduction in the intensity of joint pains and in the duration of morning stiffness, as well as in the number of tender and inflamed joints. The improvement was associated with the duration of treatment. Remicade therapy resulted in diminished inflammatory activity. Before treatment the high activity of PA, estimated from the DAS 4 index, was determined in 71,4% of the patients; and after the second infusion it was seen only in 5%. After three infusions or more, there were a larger number of patients with 70ACR scores, i.e. those with a very good effect of therapy; and after 5 infusions; the number of such patients was as high as 91%. According with the EULAR criteria, a good therapeutic effect was observed in 89% of cases. The course of psoriasis was less pronounced. PA remission occurred in every 6 and every 3 patients after the second and fifth infusions, respectively. Conclusion. Remicade is the most effective drug among the available anti-inflammatory ones for the treatment of PA. It strongly affects the major syndromes of this disease.Цель исследования - изучение эффективности и переносимости инфликсимаба (Ремикейд) при основных синдромах псориатиче-ского артрита (ПА). Материал и методы. Исследование основано на лечении Ремикейдом 22 больных ПА с тяжелым и среднетяжельм течением, полиартритическим, остеолитическим и спондилоартритическим вариантами сутавного синдрома, распространенным вульгарным, пустулезным и эритродермическим псориазом. Воспалительную активность определяли по DAS 4, а эффективность терапии - по критериям АCR и EULAR. О тяжести псориаза судили по индексу PASI. У всех больных наблюдались неэффективность или непереносимость базисных противовоспалительных препаратов (БПВП). Терапию Ремикейдом в сочетании с метотрексатом проводили 7 больным, остальные пациенты принимали Ремикейд без БПВП. Препарат вводили внутривенно из расчета 5 мг/кг по общепринятой схеме. Оценена эффективность первых 5 инфузий Ремикейда. Результаты исследования. Уже после 1-й инфузии инфликсимаба наблюдалось достоверное уменьшение интенсивности боли в суставах и продолжительности утренней скованности, а также числа болезненных и воспаленных суставов. Улучшение состояния больных ассоциировалось с длительностью лечения. Под влиянием терапии Ремикейдом отмечалось достоверное снижение воспалительной активности. До начала лечения высокая активность ПА по индексу DAS 4 определялась у 71,4% больных, а после 2-й инфузии препарата - только у 5%. После 3 инфузий и более констатировано большее число больных с ACR 70, т.е. с очень хорошим эффектом терапии, а после 5 инфузий число таких больных достигло 91%. Хороший эффект терапии по критериям EULAR наблюдался в 89% случаев. Не менее выраженной была и динамика псориаза. Ремиссия ПА после 2-й инфузии Ремикейда наступила у каждого 6-го больного, а после 5-й инфузии - у каждого 3-го. Заключение. Ремикейд является наиболее эффективным из имеющихся противовоспалительных препаратов для лечения ПА. Он активно воздействует на основные синдромы этого заболевания

Ботулотоксин типа А (диспорт) в лечении хронических форм первичной головной боли

The aim of this investigation is to study the effect of BTA on the cerebral blood flow in patients with chronic daily headache. The analysis of Doppler ultrasonography and transcranial Dopplergraphy findings has shown the following: after the treatment 34% of the patients had no extravasal effect and in 66% of the patients it became moderate and after the treatment normal venous outflow was found in 58% of the patients . The results of the pilot study demonstrate the effect of BT-A injection on the cerebral blood flow by means of optimizing both the arterial blood flow and the venous outflow from the cavity of the skull.Для терапии хронической ежедневной головной боли (ХЕГБ) использовали препарат диспорт. После лечения у 34% пациентов экстравазальное влияние не выявлялось, а у 66% оно стало умеренным. После лечения отмечена нормализация венозного оттока у 58% пациентов, из которых только у 10% изменения сохранили свою выраженность. Полученные результаты свидетельствуют об улучшении показателей церебрального кровотока больных с ХЕГБ на фоне инъекций ботулотоксина типа А

Therapy for psoriatic arthritis with infliximab

Objective: to study the efficacy and tolerability of infliximab (Remicade) in the major syndromes of psoriatic arthritis (PA). Subjects and methods. The study was based on Remicade therapy in 22 patients with severe and moderate PA with polyarthritic, osteolytic and spondyloarthritic types of the joint syndrome, generalized psoriasis vulgar and erythrodermata, and pustular psoriasis. Inflammatory activity was determined by DAS 4 and the efficiency of therapy was evaluated by the ACR and EULAR criteria. The severity of psoriasis was judged from the PASI index. Inefficiency or intolerability of essential anti-inflammatory drugs (EAIDs) was observed in all the patients. Therapy with Remicade in combination with methotrexate was performed in 7 patients; the other patients took Remicade without EAIDs. The drug was intravenously injected in a dose of 5 mg/kg by the generally accepted scheme. The efficacy of the first 5 Remicade infusions was evaluated. Results. Just after the first infliximab infusion, there was a significant reduction in the intensity of joint pains and in the duration of morning stiffness, as well as in the number of tender and inflamed joints. The improvement was associated with the duration of treatment. Remicade therapy resulted in diminished inflammatory activity. Before treatment the high activity of PA, estimated from the DAS 4 index, was determined in 71,4% of the patients; and after the second infusion it was seen only in 5%. After three infusions or more, there were a larger number of patients with 70ACR scores, i.e. those with a very good effect of therapy; and after 5 infusions; the number of such patients was as high as 91%. According with the EULAR criteria, a good therapeutic effect was observed in 89% of cases. The course of psoriasis was less pronounced. PA remission occurred in every 6 and every 3 patients after the second and fifth infusions, respectively. Conclusion. Remicade is the most effective drug among the available anti-inflammatory ones for the treatment of PA. It strongly affects the major syndromes of this disease