6 research outputs found
ΠΠΠΠ£ΠΠΠΠΠΠΠ’ΠΠ§ΠΠ‘ΠΠΠ ΠΠ‘ΠΠΠΠ’Π« Π ΠΠΠΠΠΠ Π ΠΠΠΠΠ’ΠΠΠΠΠΠΠ ΠΠ Π’Π ΠΠ’Π
The study is aimed to investigate the distribution of alleles of HLA-DRB1 gene in patients with early rheumatoid arthritis and healthy individuals in Russian population, and evaluate their significance as molecular genetic markers of rheumatoid arthritis predisposition and protection. The association between alleles of HLA-DRB1 genes, antibodies to cyclic citrullinated peptides and IgM rheumatoid factor was also studied. Low and high resolution HLA-DRB1 genotyping were compared. In the cohort of patients with early rheumatoid arthritis, the alleles of HLA-DRB1 gene were found to be markers of rheumatoid arthritis protection/risk, especially in the homozygous state. They determined production of antibodies to cyclic citrullinated peptides but were not associated with rheumatoid factor IgM levels. These findings support different autoimmune mechanisms of rheumatoid arthritis pathogenesis.Β ΠΠ·ΡΡΠ΅Π½ΠΎ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π°Π»Π»Π΅Π»Π΅ΠΉ Π³Π΅Π½Π° HLA-DRB1 Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ°Π½Π½ΠΈΠΌ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΌ Π°ΡΡΡΠΈΡΠΎΠΌ ΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π»ΠΈΡ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ ΠΈ ΠΎΡΠ΅Π½Π΅Π½Π° ΠΈΡ
Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΏΡΠ΅Π΄ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΈ ΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ°. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΡΠΈΠ»Π° Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ²ΡΠ·ΠΈ Π°Π»Π»Π΅Π»Π΅ΠΉ Π³Π΅Π½Π° HLA-DRB1 Ρ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ΅ΠΉ Π°Π½ΡΠΈΡΠ΅Π» ΠΊ ΡΠΈΠΊΠ»ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΈΡΡΡΠ»Π»ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΠΏΠ΅ΠΏΡΠΈΠ΄Π°ΠΌ ΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠΌΡ ΡΠ°ΠΊΡΠΎΡΡ ΠΊΠ»Π°ΡΡΠ° Π. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π²ΡΡΠΎΠΊΠΎ- ΠΈ Π½ΠΈΠ·ΠΊΠΎΡΠ°Π·ΡΠ΅ΡΠ°ΡΡΠ΅Π³ΠΎ Π³Π΅Π½ΠΎΡΠΈΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π°Π»Π»Π΅Π»Π΅ΠΉ HLA-DRB1. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ°Π½Π½ΠΈΠΌ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΌ Π°ΡΡΡΠΈΡΠΎΠΌ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ Π°Π»Π»Π΅Π»ΠΈ Π³Π΅Π½Π° HLA-DRB1, ΡΠ²Π»ΡΡΡΠΈΠ΅ΡΡ ΠΌΠ°ΡΠΊΠ΅ΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° ΠΈ ΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ°, Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½ΠΈΡΡΡΡΠΈΠ΅ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΡ Π°Π½ΡΠΈΡΠ΅Π» ΠΊ ΡΠΈΠΊΠ»ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΈΡΡΡΠ»Π»ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΠΏΠ΅ΠΏΡΠΈΠ΄Π°ΠΌ, Π½ΠΎ Π½Π΅ Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Ρ Π°Π½ΡΠΈΡΠ΅Π»Π°ΠΌΠΈ ΠΊΠ»Π°ΡΡΠ° M ΠΊ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠΌΡ ΡΠ°ΠΊΡΠΎΡΡ. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΌΠΎΠ³ΡΡ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΠΎΠ²Π°ΡΡ ΠΎ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π°ΡΡΠΎΠΈΠΌΠΌΡΠ½Π½ΡΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°Ρ
ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π° ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ°.Β
The prediction and long-term maintenance of low disease activity during therapy with disease modifying anti-inflammatory drugs for rheumatoid arthritis
Therapy with biological agents (biologics) over the past few years has become an important part of the strategy of medical treatment of patients with rheumatoid arthritis who respond insufficiently to the disease modifying anti-inflammatory drugs. The possibility to predict response to biologics is of special importance. Factors associated with good response to TNF-inhibitors are very different: age, liver and kidney function, body mass index, concomitant therapy, immunogenicity, the presence of ACPA and the rheumatoid factor, the cytokine profile, genetics, smoking, previous therapy by biologics etc. Another factor that significantly affects the long-term prognosis of biologic therapy is the primary response to treatment. Inhibitors of TNF-Ξ± as a whole is characterized by the development of the most marked clinical response within the first 12β24 weeks of treatment that can sustain for 12 months or more. Certolizumab pegol is characterized by rapid development of marked clinical response to treatment against disease activity and function with maintaining consistent improvement over the years, and the prognosis can be determined in most patients by the response to therapy in the first 12 weeks. We present a clinical case
ΠΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π½ΠΈΠ·ΠΊΠΎΠΈΜ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π½Π° ΡΠΎΠ½Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΠΌΠΈ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ ΠΏΡΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠΌ Π°ΡΡΡΠΈΡΠ΅
Therapy with biological agents (biologics) over the past few years has become an important part of the strategy of medical treatment of patients with rheumatoid arthritis who respond insufficiently to the disease modifying anti-inflammatory drugs. The possibility to predict response to biologics is of special importance. Factors associated with good response to TNF-inhibitors are very different: age, liver and kidney function, body mass index, concomitant therapy, immunogenicity, the presence of ACPA and the rheumatoid factor, the cytokine profile, genetics, smoking, previous therapy by biologics etc. Another factor that significantly affects the long-term prognosis of biologic therapy is the primary response to treatment. Inhibitors of TNF-Ξ± as a whole is characterized by the development of the most marked clinical response within the first 12β24 weeks of treatment that can sustain for 12 months or more. Certolizumab pegol is characterized by rapid development of marked clinical response to treatment against disease activity and function with maintaining consistent improvement over the years, and the prognosis can be determined in most patients by the response to therapy in the first 12 weeks. We present a clinical case.Β Π’Π΅ΡΠ°ΠΏΠΈΡ Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΠΌΠΈ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ (ΠΠΠΠ) Π·Π° ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ Π»Π΅Ρ ΡΡΠ°Π»Π° Π²Π°ΠΆΠ½Π΅ΠΈΜΡΠ΅ΠΈΜ ΡΠ°ΡΡΡΡ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΌ Π°ΡΡΡΠΈΡΠΎΠΌ (Π Π), Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ ΠΎΡΠ²Π΅ΡΠ°ΡΡΠΈΡ
Π½Π° ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠ΅ Π±Π°Π·ΠΈΡΠ½ΡΠ΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ ΠΎΡΠΎΠ±ΡΡ Π²Π°ΠΆΠ½ΠΎΡΡΡ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΠ²Π΅ΡΠ° Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡ. Π€Π°ΠΊΡΠΎΡΡ, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Ρ Ρ
ΠΎΡΠΎΡΠΈΠΌ ΠΎΡΠ²Π΅ΡΠΎΠΌ Π½Π° ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ ΡΠ°ΠΊΡΠΎΡΠ° Π½Π΅ΠΊΡΠΎΠ·Π° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ (ΠΈ-Π€ΠΠ) Ξ±, Π²Π΅ΡΡΠΌΠ° ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½Ρ: Π²ΠΎΠ·ΡΠ°ΡΡ, ΡΡΠ½ΠΊΡΠΈΡ ΠΏΠ΅ΡΠ΅Π½ΠΈ ΠΈ ΠΏΠΎΡΠ΅ΠΊ, ΠΈΠ½Π΄Π΅ΠΊΡ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π°, ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ, ΠΈΠΌΠΌΡΠ½ΠΎΠ³Π΅Π½Π½ΠΎΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°, Π½Π°Π»ΠΈΡΠΈΠ΅ Π°Π½ΡΠΈΡΠΈΡΡΡΠ»Π»ΠΈΠ½ΠΎΠ²ΡΡ
Π°Π½ΡΠΈΡΠ΅Π» ΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΠ°ΠΊΡΠΎΡΠ°, ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΡΠΈΜ ΠΏΡΠΎΡΠΈΠ»Ρ, Π³Π΅Π½Π΅ΡΠΈΠΊΠ°, ΠΊΡΡΠ΅Π½ΠΈΠ΅, ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΠΠΠ ΠΈ Π΄Ρ. ΠΡΠ΅ ΠΎΠ΄ΠΈΠ½ ΡΠ°ΠΊΡΠΎΡ, ΠΊΠΎΡΠΎΡΡΠΈΜ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠΈΜ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠΠΠ β ΡΡΠΎ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΡΠΈΜ ΠΎΡΠ²Π΅Ρ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅. ΠΠ»Ρ ΠΈ-Π€ΠΠΞ± Π² ΡΠ΅Π»ΠΎΠΌ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠ²ΡΡ
12β24 Π½Π΅Π΄ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΠΊΠΎΡΠΎΡΡΠΈΜ ΡΠΎΡ
ΡΠ°Π½ΡΠ΅ΡΡΡ Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ 12 ΠΌΠ΅Ρ ΠΈ Π±ΠΎΠ»Π΅Π΅. ΠΠ»Ρ ΡΠ΅ΡΡΠΎΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΏΡΠ³ΠΎΠ»Π° Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΠΎ Π±ΡΡΡΡΠΎΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ Ρ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠΈΜΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ ΠΌΠ½ΠΎΠ³ΠΈΡ
Π»Π΅Ρ, ΠΏΡΠΈ ΡΡΠΎΠΌ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎ ΠΎΡΠ²Π΅ΡΡ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠ²ΡΡ
12 Π½Π΅Π΄. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅.
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠΎΠ΄ΠΊΠΎΠΆΠ½ΠΎΠΉ ΡΠΎΡΠΌΡ ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°ΡΠ° ΡΠ°Π·Π½ΡΡ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅: ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅
Background: Methotrexate is the main syntheticΒ disease-modifying antirheumatic drug for theΒ treatment of rheumatoid arthritis (RA), psoriaticΒ arthritis (PsA) and other immunoinflammatoryΒ conditions. In the recent years, the subcutaneousΒ form of methotrexate (SC MTX), particularly asΒ ready-to-use syringes, has been increasingly usedΒ worldwide. Currently, several generics of SC MTXΒ from different manufacturers are available. In literatureΒ we could not find any publications on theΒ comparison of SC MTX generics.Aim: To evaluateΒ the possibility to effectively use various SC MTXsΒ for the treatment of RA and PsA in real clinicalΒ practice. Materials and methods: Patients olderΒ than 18 years old with a diagnosis of RA by ACRΒ 1987 or ACR / EULAR 2010 criteria or diagnosis ofΒ PsA by CASPAR criteria with indications for SC MTXΒ were included in this open-label 6-month observationalΒ study βTherapy of Rheumatoid ArthritisΒ with Methotrexate in the Subcutaneous Form inΒ Clinical Practice (TRAMPLIN)β. TRAMPLIN includedΒ two study periods: 1) a retrospective study of theΒ safety of SC MTX from various manufacturers inΒ clinical practice, according to patients' medical records;Β 632 patients (67.2% female, 32.8% male) onΒ SC MTX were identified, and the number of adverseΒ reactions recorded in the documentation (spontaneousΒ reports) was determined; 2) a prospectiveΒ study of the treatment duration and the reasonsΒ for the withdrawal of SC MTX from different manufacturers,Β which included 69 patients with RAΒ and PsA. SC MTXs from three manufacturers wereΒ used in this study, namely Metoject (Medac GmbH,Β Germany); MΓ©tortrites (S.C. Rompharm CompanyΒ S.R.L., Romania); Methotrexat Ebewe (SandozΒ Pharmaceuticals D.D., Slovenia).Results: In theΒ retrospective part of the study very few adverseΒ events (AEs) were registered, which were relatedΒ to SC MTX in the physician's opinion (41 patients,Β or 6.5%). Their incidence was higher in methotrexate-naΓ―ve patients. In the prospective part of theΒ study at 3 months after the start of SC MTX therapy,Β 25 patients (36.2%) changed the treatmentΒ regimen (switched between the study drugs or toΒ oral methotrexate). The main reasons for switchingΒ (20.3%) were βnon-medicalβ events in the outpatients.Β AEs ranked second as a reason for the drugΒ withdrawal (14.5%), irrespective of the manufacturer.Β At 6 month of the study, 38% patients wereΒ treated with Metoject, 30% with MethotrexatΒ Ebewe, 28% with MΓ©tortrites, and 4% of patientsΒ Β switched to oral methotrexate.Conclusion: ThisΒ first Russian study of SC MTX generics from threeΒ different manufacturers confirmed a good SC MTXΒ safety profile in a large clinical sample and showedΒ good retention rates for therapy: by the end of theΒ observation, 96% of the patients with availableΒ follow-up data remained on SC MTX. All three SCΒ MTXs from different manufacturers were compatibleΒ in terms of safety, tolerability, and drug survival.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°Ρ β ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π±Π°Π·ΠΈΡΠ½ΡΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΉΒ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ, ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ° ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΈΠΌΠΌΡΠ½ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π³ΠΎΠ΄Ρ Π² ΠΌΠΈΡΠ΅Β Π²ΡΠ΅ ΡΠΈΡΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΡΡΡ ΠΏΠΎΠ΄ΠΊΠΎΠΆΠ½Π°Ρ ΡΠΎΡΠΌΠ° ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°ΡΠ° (ΠΠ ΠΠ’), ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π² Π²ΠΈΠ΄Π΅ Π³ΠΎΡΠΎΠ²ΡΡ
Β ΡΠΏΡΠΈΡΠ΅Π². Π‘Π΅Π³ΠΎΠ΄Π½Ρ Π΄ΠΎΡΡΡΠΏΠ½ΠΎ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΡΠ°Π·Π½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ. Π ΡΡΡΡΠΊΠΎ- ΠΈ Π°Π½Π³Π»ΠΎΡΠ·ΡΡΠ½ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ Π½Π°ΠΌ Π½Π΅ ΡΠ΄Π°Π»ΠΎΡΡ Π½Π°ΠΉΡΠΈΒ ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΉ, ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π½ΡΡ
ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΡ Π³Π΅Π½Π΅ΡΠΈΠΊΠΎΠ² ΠΠ ΠΠ’.Π¦Π΅Π»Ρ β ΠΎΡΠ΅Π½ΠΈΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡΒ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ²Β ΠΠ ΠΠ’ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΈ ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ° Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΎΡΠΊΡΡΡΠΎΠ΅ 6-ΠΌΠ΅ΡΡΡΠ½ΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Β«Π’Π΅ΡΠ°ΠΏΠΈΡΒ Π Π΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΡΡΡΠΈΡΠ° ΠΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°ΡΠΎΠΌΒ Π² ΠΠΎΠ΄ΠΊΠΎΠΆΠ½ΠΎΠΉ ΡΠΎΡΠΌΠ΅ Π² ΠΊΠΠΠΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅Β (Π’Π ΠΠΠΠΠΠ)Β» Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ Π±ΠΎΠ»ΡΠ½ΡΠ΅ ΡΡΠ°ΡΡΠ΅Β 18 Π»Π΅Ρ, ΠΈΠΌΠ΅ΡΡΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ° ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ACR (American College ofΒ Rheumatology β ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΈΠΉ ΠΊΠΎΠ»Π»Π΅Π΄ΠΆ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ) 1987 Π³. ΠΈΠ»ΠΈ ACR/EULAR (EuropeanΒ League Against Rheumatism β ΠΠ²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠ°Ρ Π°Π½ΡΠΈΡΠ΅Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π»ΠΈΠ³Π°) 2010 Π³., Π»ΠΈΠ±ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ° ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ CASPARΒ (Classification Criteria for Psoriatic Arthritis βΒ ΠΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΠ°), ΠΈΠΌΠ΅ΡΡΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΊ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡΒ ΠΠ ΠΠ’. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Β«Π’Π ΠΠΠΠΠΠΒ» ΡΠΎΡΡΠΎΡΠ»ΠΎ ΠΈΠ·Β Π΄Π²ΡΡ
ΡΡΠ°Π³ΠΌΠ΅Π½ΡΠΎΠ²: 1) ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΠ ΠΠ’ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌΒ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠΈ; Π±ΡΠ»ΠΎ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½ΠΎ 632 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (67,2% ΠΆΠ΅Π½ΡΠΈΠ½,Β 32,8% ΠΌΡΠΆΡΠΈΠ½), ΠΏΠΎΠ»ΡΡΠ°Π²ΡΠΈΡ
ΠΠ ΠΠ’, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΎΒ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠΈΒ (ΡΠΏΠΎΠ½ΡΠ°Π½Π½ΡΠ΅ ΡΠΎΠΎΠ±ΡΠ΅Π½ΠΈΡ) Π½Π΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ Π½Π° ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ; 2) ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΡΠΈΡΠΈΠ½Β ΠΏΡΠ΅ΡΡΠ²Π°Π½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠ ΠΠ’ ΡΠ°Π·Π½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ, Π² ΡΠ°ΠΌΠΊΠ°Ρ
Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΡΠ°Π³ΠΌΠ΅Π½ΡΠ° ΠΏΡΠΎΡΠ»Π΅ΠΆΠ΅Π½ΠΎ 69 Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΌ ΠΈ ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ Π°ΡΡΡΠΈΡΠΎΠΌ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΡΡΒ ΠΠ ΠΠ’ ΡΡΠ΅Ρ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ: ΠΠ΅ΡΠΎΠ΄ΠΆΠ΅ΠΊΡ (MedacΒ GmbH, ΠΠ΅ΡΠΌΠ°Π½ΠΈΡ); ΠΠ΅ΡΠΎΡΡΡΠΈΡ (S.C. RomfarmΒ Company S.R.L., Π ΡΠΌΡΠ½ΠΈΡ); ΠΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°Ρ-ΠΠ±Π΅Π²Π΅(Sandoz, Π‘Π»ΠΎΠ²Π΅Π½ΠΈΡ). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΠΏΠ΅ΡΠ²ΠΎΠΌΒ ΡΡΠ°Π³ΠΌΠ΅Π½ΡΠ΅ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ ΠΎΡΠ΅Π½Ρ Π½Π΅Π±ΠΎΠ»ΡΡΠΎΠ΅Β ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π½Π΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ, ΠΏΠΎ ΠΌΠ½Π΅Π½ΠΈΡ Π²ΡΠ°ΡΠ΅ΠΉ, ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΠ ΠΠ’, βΒ Ρ 41 (6,5%) Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ, ΠΏΡΠΈ ΡΡΠΎΠΌ ΡΠ°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡΒ Π΄Π°Π½Π½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ Π±ΡΠ»Π° Π²ΡΡΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±Π΅Π·Β ΠΎΠΏΡΡΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°ΡΠΎΠΌ. Π ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅ΡΠ΅Π· 3 ΠΌΠ΅ΡΡΡΠ° ΠΏΠΎΡΠ»Π΅ Π½Π°ΡΠ°Π»Π°Β ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠ ΠΠ’ 25 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (36,2%) ΠΈΠ·ΠΌΠ΅Π½ΠΈΠ»ΠΈΒ ΡΡ
Π΅ΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ (ΠΏΠ΅ΡΠ΅ΠΊΠ»ΡΡΠ°Π»ΠΈΡΡ ΠΌΠ΅ΠΆΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ, Π½Π° ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°Ρ per os).Β ΠΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΏΠ΅ΡΠ΅ΠΊΠ»ΡΡΠ΅Π½ΠΈΠΉ (20,3%)Β ΡΡΠ°Π»ΠΈ ΡΠΎΠ±ΡΡΠΈΡ Β«Π½Π΅ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎΒ» Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ°Β Π½Π° Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅, Π½Π° Π²ΡΠΎΡΠΎΠΌ ΠΌΠ΅ΡΡΠ΅ Π±ΡΠ»ΠΈΒ Π½Π΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΠ΅Π°ΠΊΡΠΈΠΈ (14,5%), ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΠ΄ΠΈΠ½Π°ΠΊΠΎΠ²ΠΎ ΡΠ°ΡΡΠΎ ΡΠ»ΡΠΆΠΈΠ»ΠΈ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΏΠ΅ΡΠ΅ΠΊΠ»ΡΡΠ΅Π½ΠΈΡ Π΄Π»Ρ ΠΠ ΠΠ’ ΡΠ°Π·Π½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ. Π§Π΅ΡΠ΅Π·Β 6 ΠΌΠ΅ΡΡΡΠ΅Π² 38% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ ΠΠ΅ΡΠΎΠ΄ΠΆΠ΅ΠΊΡ,Β 30% β ΠΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°Ρ-ΠΠ±Π΅Π²Π΅, 28% β ΠΠ΅ΡΠΎΡΡΡΠΈΡ,Β 4% Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠ΅ΡΠ΅ΡΠ»ΠΈ Π½Π° ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°Ρ per os.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΠ²ΠΎΠ΅ Π² Π ΠΎΡΡΠΈΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅Β Π³Π΅Π½Π΅ΡΠΈΠΊΠΎΠ² ΠΠ ΠΠ’ ΡΡΠ΅Ρ
ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ Π½Π° Π±ΠΎΠ»ΡΡΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π΅Β ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠ΄ΠΈΠ»ΠΎ Π²ΡΡΠΎΠΊΠΈΠΉ ΠΏΡΠΎΡΠΈΠ»Ρ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈΒ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΈ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΎ Ρ
ΠΎΡΠΎΡΠΈΠ΅Β ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ: ΠΊ ΠΊΠΎΠ½ΡΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ ΠΠ ΠΠ’ ΠΎΡΡΠ°Π»ΠΈΡΡ 96% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡ ΡΠΈΡΠ»Π° ΠΏΡΠΎΡΠ»Π΅ΠΆΠ΅Π½Π½ΡΡ
Β Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅. ΠΡΠ΅ ΡΡΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΠ ΠΠ’ ΡΠ°Π·Π½ΡΡ
Β ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ Π±ΡΠ»ΠΈ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡ ΠΌΠ΅ΠΆΠ΄Ρ ΡΠΎΠ±ΠΎΠΉ ΠΏΠΎ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ, ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠΈΠΌΠΎΡΡΠΈ ΠΈ ΡΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
The influence of CCPA and RF on the five-year outcomes in patients with early rheumatoid arthritisΠΈΠ²Π΅
Objective: to study the influence of CCPA and RF on 5-year outcomes in patients with early rheumatoid arthritis (RA). Subjects and methods. 204 patients with early RA (0,05. Between RF (+) (n=138) and RF (-) (n=66) groups we did not find differences (p>0,05). Radiological damage in the CCPA(+) patients was more pronounced from the second year of the observation. Baseline, after 1 year SHS (MΒ±o) was 19,7Β±10,5 (compared 15,1Β±8,9), 25,4Β±16,8 (20,3Β±12,2), p>0,05. From 2 to 5 years β 33,5Β±20,8 (25,3Β±14,2), 40,8Β±26,8 (31,9Β±20,2), 48,0Β±28,8 (37,2Β±22,6), 55,6Β±30,5 (44,0Β±24,5), respectively, p<0,05. This trend was determined in RF-positive patients. Conclusion. The CCPA- and RF-positive patients have the worst of 5-year radiological outcomes. CCPA-positive patients also have the worst clinical course during the first 4 years
ΠΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈΡΡ ΠΎΠ΄Π° COVID-19: ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ 13 585 Π±ΠΎΠ»ΡΠ½ΡΡ , Π½Π°Ρ ΠΎΠ΄ΠΈΠ²ΡΠΈΡ ΡΡ Π½Π° ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² Π±ΠΎΠ»ΡΠ½ΠΈΡΠ°Ρ ΠΠΎΡΠΊΠΎΠ²ΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ
Background: The COVID-19 pandemic is seriously affecting the society and economy of many countries, including the Russian Federation. Identifying of the major risk factors for an unfavorable outcome could help save lives and reduce the disease burden. Until now, no results of the studies on this issue based on the Russian clinical material have been published. Aim: To evaluate the effects of comorbidities on the outcome (discharge or hospital death rates) in patients hospitalized with a diagnosis of COVID-19.Materials and methods: We analyzed a database of 13,585 patients who were treated in 66 hospitals functioning under the obligatory health insurance system of the Moscow Region, with a final diagnosis of "COVID-19, virus identified" (ICD 10 code U07.1) from April 1, 2020 to June 23, 2020 (53.7% women, 46.3% men, mean (Β± SD) age 56.5 Β± 14.9 years (median 57 [46; 67])). In all patients, the diagnosis of COVID-19 was confirmed by polymerase chain reaction (PCR) for the SARS-CoV-2 virus in nasopharyngeal or oropharyngeal swabs. 93.8% of the patients showed signs of interstitial viral pneumonia (87.9% confirmed by computed tomography of the lungs, 5.9% by standard chest X-ray). All patients received the standard treatment according to the "Temporary Guidelines on prevention, diagnosis and treatment of the new coronavirus infection (COVID-19), version 7 (03.06.2020)β from the Ministry of Health of the Russian Federation. 1518 (11.2%) patients had at least one comorbid condition, the most frequent being arterial hypertension (AH), ischemic heart disease (IHD), and diabetes mellitus (DM). In 71 female patients, COVID-19 occurred during pregnancy. By June 23, 2020, 10761 (79.2%) patients have been discharged from hospitals with recovery, improvement, or stabilization (the latter was considered a conditionally favorable outcome). 1246 patients died, that transfers into the in-hospital death rates of about 9.2% (unfavorable outcome). The rest of 1578 (11.6%) patients continued their treatment, or were transferred to other medical units for the continuation of care. The comparative analysis included patients (total, n = 12,007) with favorable (n = 10,761) and unfavorable (n = 1246) inpatient outcomes. The age-adjusted Charlson index was used to quantify the severity of comorbidity.Results: In the patients without any comorbidity, the in-hospital death rate was 9.4%. At least one comorbidity increased the incidence of unfavorable outcome to 13.9% (p 0.001), and multiple comorbidities to 24.8% (p 0.001). The following specific conditions significantly increased the likelihood of an unfavorable outcome (p 0.05): DM, mental disorders, morbid obesity, IHD, AH, stroke (including past history), myocardial infarction (including past history), chronic heart failure, heart arrhythmias, cancer, and chronic kidney disease. Tuberculosis, HIV/AIDS, trauma / surgical disorders, and pregnancy were not associated with higher rates of unfavorable outcomes, but these patients were significantly younger than patients without comorbidities and with comorbidities with higher death rates. The age-adjusted Charlson index of 3 was associated with a more than 2-fold increase in the in-hospital death rates (25.2%, p 0.001).Conclusion: Comorbidity is one of the drivers in the prognosis of in-hospital death rates in patients with COVID-19. However, it should be considered in the context of the patient age-related characteristics. The Charlson Age-Adjusted Comorbidity Index is a useful tool for assessment of the COVID-19 prognosis. The prognosis should be considered serious at a score of 3 or more.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ°Π½Π΄Π΅ΠΌΠΈΡ COVID-19 Π½Π°Π½ΠΎΡΠΈΡ ΡΠ΅ΡΡΠ΅Π·Π½ΡΠΉ ΡΡΠ΅ΡΠ± ΠΎΠ±ΡΠ΅ΡΡΠ²Ρ ΠΈ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΠΊΠ΅ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΡΡΡΠ°Π½, Π²ΠΊΠ»ΡΡΠ°Ρ Π ΠΎΡΡΠΈΠΉΡΠΊΡΡ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΡ. ΠΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° ΠΌΠΎΠΆΠ΅Ρ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°ΡΡ ΡΠΏΠ°ΡΠ΅Π½ΠΈΡ ΠΆΠΈΠ·Π½ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π±ΡΠ΅ΠΌΠ΅Π½ΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π² Π΄Π°Π½Π½ΠΎΠΌ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΈ Π½Π° ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π΅ Π½Π΅ ΠΎΠΏΡΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½ΠΎ.Π¦Π΅Π»Ρ - ΠΎΡΠ΅Π½ΠΊΠ° Π²Π»ΠΈΡΠ½ΠΈΡ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ Π½Π° ΠΈΡΡ
ΠΎΠ΄ (Π²ΡΠΏΠΈΡΠΊΠ°, Π²Π½ΡΡΡΠΈΠ±ΠΎΠ»ΡΠ½ΠΈΡΠ½Π°Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π½Π°Ρ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Π½Π° ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Β«COVID-19Β».ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ Π±Π°Π·Ρ Π΄Π°Π½Π½ΡΡ
, Π²ΠΊΠ»ΡΡΠ°ΡΡΡΡ 13 585 Π±ΠΎΠ»ΡΠ½ΡΡ
, Π½Π°Ρ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Ρ 1 Π°ΠΏΡΠ΅Π»Ρ ΠΏΠΎ 23 ΠΈΡΠ½Ρ 2020 Π³. Π½Π° ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² 66 Π±ΠΎΠ»ΡΠ½ΠΈΡΠ°Ρ
, ΡΠ°Π±ΠΎΡΠ°ΡΡΠΈΡ
Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ ΠΎΠ±ΡΠ·Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΡΡΡΠ°Ρ
ΠΎΠ²Π°Π½ΠΈΡ ΠΠΎΡΠΊΠΎΠ²ΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ, Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Β«COVID-19, Π²ΠΈΡΡΡ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Β» (ΠΊΠΎΠ΄ U07.1 ΠΏΠΎ ΠΠΠ-10). ΠΠ· Π½ΠΈΡ
ΠΆΠ΅Π½ΡΠΈΠ½ Π±ΡΠ»ΠΎ 53,7%, ΠΌΡΠΆΡΠΈΠ½ - 46,3%; ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ ΡΠΎΡΡΠ°Π²ΠΈΠ» 56,5 Β± 14,9 Π³ΠΎΠ΄Π° (M Β± SD, ΠΌΠ΅Π΄ΠΈΠ°Π½Π° 57 [46; 67] Π»Π΅Ρ). Π£ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄ΠΈΠ°Π³Π½ΠΎΠ· COVID-19 Π±ΡΠ» ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΠΎΠ»ΠΈΠΌΠ΅ΡΠ°Π·Π½ΠΎΠΉ ΡΠ΅ΠΏΠ½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ Π½Π° Π²ΠΈΡΡΡ SARS-CoV-2, ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΏΠΎΠ»ΡΡΠ΅Π½ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΌΠ°Π·ΠΊΠ° ΠΈΠ· Π½ΠΎΡΠΎΠ³Π»ΠΎΡΠΊΠΈ ΠΈ ΡΠΎΡΠΎΠ³Π»ΠΎΡΠΊΠΈ. Π£ 93,8% Π±ΠΎΠ»ΡΠ½ΡΡ
Π±ΡΠ»ΠΈ Π²ΡΡΠ²Π»Π΅Π½Ρ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΡΡΡΠΈΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ (Ρ 87,9% Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
, Ρ 5,9% - ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ³ΡΠ°ΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
). ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΡ ΠΠΈΠ½ΠΈΡΡΠ΅ΡΡΡΠ²Π° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ Β«ΠΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ. ΠΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ°, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ (COVID-19)Β», Π²Π΅ΡΡΠΈΡ 7 (03.06.2020). Π£ 1518 (11,2%) Π±ΠΎΠ»ΡΠ½ΡΡ
Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ Ρ
ΠΎΡΡ Π±Ρ ΠΎΠ΄Π½ΠΎ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅; Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌΠΈ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ Π±ΡΠ»ΠΈ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½Π°Ρ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΡ, ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΡΠ΅ΡΠ΄ΡΠ° ΠΈ ΡΠ°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ. Π£ 71 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ COVID-19 ΡΠ°Π·Π²ΠΈΠ»ΡΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ. Π 23 ΠΈΡΠ½Ρ 2020 Π³. 10 761 (79,2%) Π±ΠΎΠ»ΡΠ½ΠΎΠΉ Π²ΡΠΏΠΈΡΠ°Π½ ΠΈΠ· ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° Π² ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ ΠΈΠ·Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΈΠ»ΠΈ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ (ΡΡΠ»ΠΎΠ²Π½ΠΎ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΈΡΡ
ΠΎΠ΄); 1246 ΡΠΌΠ΅ΡΠ»ΠΈ, ΡΡΠΎ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ Π²Π½ΡΡΡΠΈΠ±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ Π½Π° ΡΡΠΎΠ²Π½Π΅ 9,2% (Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΈΡΡ
ΠΎΠ΄); ΠΎΡΡΠ°Π»ΡΠ½ΡΠ΅ 1578 (11,6%) ΠΎΡΡΠ°Π²Π°Π»ΠΈΡΡ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΈΠ»ΠΈ Π±ΡΠ»ΠΈ ΠΏΠ΅ΡΠ΅Π²Π΅Π΄Π΅Π½Ρ Π² Π΄ΡΡΠ³ΠΈΠ΅ Π»Π΅ΡΠ΅Π±Π½ΡΠ΅ ΡΡΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π΄Π»Ρ Π΄ΠΎΠ»Π΅ΡΠΈΠ²Π°Π½ΠΈΡ. Π ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π²ΠΎΡΠ»ΠΈ Π±ΠΎΠ»ΡΠ½ΡΠ΅ (n = 12 007) Ρ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΌ (n = 10 761) ΠΈ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΌ (n = 1246) ΠΈΡΡ
ΠΎΠ΄Π°ΠΌΠΈ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΠ»Ρ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΡΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΡΡ ΡΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΠΏΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΡ ΠΈΠ½Π΄Π΅ΠΊΡ Charlson.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ ΡΠ°ΡΡΠΎΡΠ° Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 9,4%. Π₯ΠΎΡΡ Π±Ρ ΠΎΠ΄Π½ΠΎ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΏΠΎΠ²ΡΡΠ°Π»ΠΎ ΡΠ°ΡΡΠΎΡΡ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Π΄ΠΎ 13,9% (Ρ 0,001), ΠΌΡΠ»ΡΡΠΈΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΡΡΡ - Π΄ΠΎ 24,8% (Ρ 0,001). Π‘ΡΠ΅Π΄ΠΈ ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΡΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»ΠΈ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° (Ρ 0,05) ΡΠ°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ, ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ, ΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΠ΅ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅, ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΡΠ΅ΡΠ΄ΡΠ°, Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½Π°Ρ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΡ, ΠΎΡΡΡΠΎΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ (Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅), ΠΎΡΡΡΡΠΉ ΠΈΠ½ΡΠ°ΡΠΊΡ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° (Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅), Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ΄Π΅ΡΠ½Π°Ρ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡ, Π°ΡΠΈΡΠΌΠΈΠΈ, ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΠΏΠΎΡΠ΅ΠΊ. Π’ΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·, Π‘ΠΠΠ, ΡΡΠ°Π²ΠΌΡ /Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ, Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡ Π½Π΅ Π±ΡΠ»ΠΈ ΡΠ²ΡΠ·Π°Π½Ρ Ρ Π±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΌ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ, Π½ΠΎ ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π±ΡΠ»ΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΌΠΎΠ»ΠΎΠΆΠ΅ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ Π±Π΅Π· ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ ΠΈ Ρ ΡΠ°ΠΊΠΎΠ²ΡΠΌΠΈ, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌΠΈ Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡΡ. Π‘ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΠΏΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΡ ΠΈΠ½Π΄Π΅ΠΊΡ Charlson, Π½Π°ΡΠΈΠ½Π°Ρ Ρ ΡΡΠΎΠ²Π½Ρ 3 Π±Π°Π»Π»Π°, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π»ΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Ρ Π΄Π²ΡΠΊΡΠ°ΡΠ½ΡΠΌ ΡΠΎΡΡΠΎΠΌ Π²Π½ΡΡΡΠΈΠ±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΠΈ (25,2%, Ρ 0,001).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΡΡΡ - ΠΎΠ΄ΠΈΠ½ ΠΈΠ· ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° Π²Π½ΡΡΡΠΈΠ±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΠΈ Ρ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ COVID-19. ΠΠ΄Π½Π°ΠΊΠΎ Π΅Π΅ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ Π² ΠΊΠΎΠ½ΡΠ΅ΠΊΡΡΠ΅ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ½Π΄Π΅ΠΊΡ ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΡΡΠΈ Charlson Ρ ΠΏΠΎΠΏΡΠ°Π²ΠΊΠΎΠΉ Π½Π° Π²ΠΎΠ·ΡΠ°ΡΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ ΡΠ΄ΠΎΠ±Π½ΡΠΌ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠΎΠΌ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΠΏΡΠΈ COVID-19, ΠΊΠΎΡΠΎΡΡΠΉ ΠΌΠΎΠΆΠ½ΠΎ ΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡ ΠΊΠ°ΠΊ ΡΠ΅ΡΡΠ΅Π·Π½ΡΠΉ ΠΏΡΠΈ Π·Π½Π°ΡΠ΅Π½ΠΈΡΡ
ΠΈΠ½Π΄Π΅ΠΊΡΠ° 3 Π±Π°Π»Π»Π° ΠΈ Π±ΠΎΠ»Π΅Π΅