ASSESSMENT OF THE COMPARATIVE EFFICIENCY AND LONG-TERM RESULTS OF TREATMENT OF RHEUMATIC ARTHRITIS

Objective of the research: to assess the comparative efficiency and long-term results of treatment of rheumatic arthritis (RA).Materials and methods: 80 RA patients have been examined. Of those, 40 patients (Group I) were administered with NSAIDs: Diclofenac 150 mg (daily dose), GCS: Prednisone 10 mg (daily dose), group II — 40 patients received NSAIDs, GCS and DMARDs: Methotrexate 10 mg (weekly dose). Dynamics of RA activity was assessed by DAS28 score at the beginning of the treatment course, then after 10 days, 6 months and 12 months, respectively, taking into account the radiological stage of the disease.Results: a comparative study of the effectiveness of therapy in dynamics immediately after in-patient treatment showed a decrease of the DAS28 score: RA patients with X-ray stage 1 by 3,4% in group I (not treated with DMARDs) and 6,4% in the group II (treated with DMARDs), compared to their first day in the clinic; X-ray stage 2: group I — 4,2%, group II — 8,5%; X-ray stage 3: reduction in DAS28 index in both groups was approx 1,8%. After 6 months of treatment a decrease in DAS28 in patients with X-ray stage 1 amounted to 6,7% and 12,9%, X-ray stage 2 — 8,3% and 6,3%, X-Ray stage 3 — 1,8% and 6,8% for two groups, respectively. After 12 months of treatment a decrease in DAS28 in patients with X-ray stage 1 amounted to 10,0% and 22,5%, X-ray stage 2 — 12,5% and 14,9%, X-Ray stage 3 — 7,1% and 13,7% for both groups, respectively.Conclusions: our research of the DMARDs effect on DAS28 score includes basic manifestations of immune and inflammatory process clearly showed the target effect of DMARDs on the rheumatoid process in dynamics of observation within 12 months. A study of the effectiveness of therapy in patients with RA showed significant efficacy of DMARDS in combination therapy with an analysis of the efficiency based on DAS28 score until stable remission of the disease

INTERACTION OF HYPERURICEMIA AND HYPERLIPIDEMIA IN MALE PATIENTS WITH PRIMARY GOUT

We studied cholesterol, LDL-C, HDL-C, VLDL-cholesterol, triglycerides, glucose, uric acid levels in 79 patients with gouty tophi and 59 patients with gout without tophi. Clinical characteristics of these groups are given. Correlations between serum levels of uric acid and lipids are analyzed

ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITISTREATED WITH METHOTREXATE

The aim of the work to study endothelial dysfunctionin young patients with rheumatoid arthritis (RA) treated with Methotrexate (MTX). The subjects of the study were 102 patients with RA. The Duplex study ofextracranial section sleepy and vertebral artery have shown beside sick RA in young age tortuosity sleepy and vertebral artery in 31,4% events with finding atherosclerotic plaque in 10,78% events, increase SUBJECT is revealed at study brahiocefalic artery beside 29,4% with age oscillation. Pathologic reactivity registered more often for the first time years from begin diseases and in 10 years then in interval from 5 before 10 years function of endothelia beside sick more often was normal. Also beside sick taken MTX more 2 years were more often revealed pathological reactivity

ASSESSMENT OF RISK FOR GASTROINTESTINAL AND CARDIOVASCULAR COMPLICATIONS ASSOCIATED WITH THE USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN THE CIS POPULATION: PRELIMINARY DATA OF THE CORONA-2 EPIDEMIOLOGICAL SURVEY

Nonsteroidal anti-inflammatory drugs (NSAIDs) are able to effectively control the major symptoms of rheumatic diseases and widely used in real clinical practice. However, they may cause serious gastrointestinal (GI) and cardiovascular (CV) events. The prevention of these events is based on the estimation of whether risk factors (RFs) are present.Objective: to estimate the presence of RFs in patients needing NSAIDs.Subjects and methods. A cross-sectional epidemiological survey was performed, during which 2021 physicians from 9 CIS countries questioned for 2 weeks at least 10 patients needing NSAIDs. The inclusion criterion was severe musculoskeletal pain (>40 mm on a 100-mm visual analogue scale (VAS)) or use of NSAIDs at the examination. Data were obtained on 21,185 patients (57.5% women and 42.5% men) (mean age 50.5±14.1 years) who had predominantly dorsalgia (56.6%) and osteoarthritis (23.5%). The mean pain value was 62.2±25.2 mm.Results. 1.7, 11.3, and 25.3% of patients had history of gastrointestinal bleeding, ulcer, or dyspepsia, respectively; people over 65 years of age constituted 16.8%; those who took low-dose aspirin (LDA) – 20.0%. The total number of patients at high risk for GI events was 29.0%. There were also common CV RFs: myocardial infarction or stroke (7.8%), coronary heart disease (17.8%), hypertension (37.7%), and diabetes mellitus (8.1%). The total number of patients at high risk for CV events (without SCOR assessment) was 23.0%. Many high-risk patients who has already used NSAIDs received no effective prevention. Thus, 62.2% of the patients at high GI risk took gastroprotective drugs; 53.2% of those at high CV risk used LDA.Conclusion. A large number of patients needing active analgesic therapy have a serious risk for drug-induced complications. This limits the possibility of using NSAIDs and determines the need for effective prevention or use of alternative methods for analgesia