ANALYSIS OF DISEASE MODIFYING DRUGS ADMINISTRATION FREGUENCY AND CAUSES OF THEIR WITHDRAWAL IN RHEUMATOID ARTHRITIS

Aim of studdy: To assess the frequency of practical application of different basic drugs in rheumatoid arthritis (RA). Material and methods: Tlxe study was conducted basing of questionner of pts and analysis of ycases by randomized sampling among 103 consequent pts (M:F= 13:90) with reliable RA (ARA, 1987) in rheumatologic department of Clinical Hospital Nol in Ekaterinburg. 74% of pts under study demonstrated systemic manifestations: anemia (in 47 pts), lymphadenopathy (in 34), rheumatoid nodules (in 15), Sjogren s syndrome (in 4), nephropathy (in 4), vascular disturbances including Raynaud s phenomenon, capillarites (by 1 pt). Results: In the course of disease basic therapy was prescribed to 88 out of103 (85.4%) pts and one and the same patient could take different basic drugs. Aminochinoline drugs prevailed, after them more frequent were immunodepressants and gold preparations. More rarely pts had sulfasalazin, cuprenil and wobenzym. In general, in 133 out of 184 cases of prescribing basic drugs they were canceled. The reason for cancellation were: prevalently absence of the drug in the pharmaceutical stores (in 48 cases) averagely in 8 months of taking the drug; then they insufficient efficacy (44 cases) averagely in 1.3 year. In 18 cases pts themselves stopped treatment averagely in 3.5 months of drug taking. Conclusion: In the majority of cases of basic drugs cancellation in RA the cause is their absence in sail especially on free of charge prescription. Cases ofself-cancellation of the drug demonstrate the need of explaining to pts the necessity> of long-term taking disease-modifying drugs

Treatment with acetaminophen/paracetamol or ibuprofen alleviates post-dose symptoms related to intravenous infusion with zoledronic acid 5 mg

Summary: Patients treated with intravenous zoledronic acid 5 mg for osteoporosis may experience post-dose influenza-like symptoms. Oral acetaminophen/paracetamol or ibuprofen administered 4 h post-infusion reduced the proportion of patients with increased oral temperature and worsening post-infusion symptom scores vs. placebo, thus providing an effective strategy for the treatment of such symptoms. Introduction: Once-yearly intravenous zoledronic acid 5 mg is a safe and effective treatment for postmenopausal osteoporosis. This study assessed whether transient influenza-like post-dose symptoms associated with intravenous infusion of zoledronic acid can be reduced by post-dose administration of acetaminophen/paracetamol or ibuprofen. Methods: In an international, multicenter, randomized, double-blind, double-dummy parallel-group study, bisphosphonate-naïve postmenopausal women with osteopenia (n = 481) were randomized to receive zoledronic acid 5 mg + acetaminophen/paracetamol (n = 135), ibuprofen (n = 137) or placebo (n = 137), or placebo + placebo (n = 72). Acetaminophen/paracetamol and ibuprofen were administered every 6 h for 3 days beginning 4 h post-infusion. Results: The proportion of patients with increased oral temperature (≥1°C above 37.5°C) and with worsening post-infusion symptom scores over 3 days was significantly lower in patients receiving ibuprofen (36.8% and 48.5%) or acetaminophen/paracetamol (37.3% and 46.3%) vs. those receiving placebo (63.5% and 75.9%, respectively; all p < 0.0001) compared with background rates of 11.1% and 16.7%, respectively, in the absence of any active treatment. Overall incidence of adverse events was comparable for patients receiving acetaminophen/paracetamol or ibuprofen. Conclusion: Oral acetaminophen/ paracetamol or ibuprofen effectively managed the transient influenza-like symptoms associated with zoledronic acid 5 mg. © 2011 International Osteoporosis Foundation and National Osteoporosis Foundation

EFFICACY OF ETANERCEPT IN PATIENTS WITH RHEUMATOID ARTHRITIS (results of the Russian multicenter ETALON study)

Objective. To evaluate the effectiveness and tolerance of Etanercept (ETN) therapy in patients with rheumatoid arthritis (RA).Material and Methods. 188 adult patients with severe and moderate RA (average DAS28 score of 6.26±0.89) subcutaneously received 50 mg/wk ETC during 24 wk along with therapy using disease-modifying antirheumatic drugs (DMARDs). The effectiveness was assessed using the EULAR and ACR20/50/70 criteria, dynamics of HAQ, SDAI, CDAI, ESR, and the C-reactive protein level.Results. By the end of the study, low activity of the disease according to EULAR (DAS28 score ≤ 3.2) was achieved in 31.9% of patients; remission (DAS28 score ≤ 2.6) was achieved in 17% of patients. ACR20/50/70 response was achieved in 72.3; 47.8 and 20.2% of patients, respectively. A decrease in the HAQ index by at least 0.25 points was achieved in 67.5% of patients. The overall EULAR response (moderate and good) was observed in 79.3% of patients; SDAI and CDAI remission/low activity was observed in 52.3 and 52.7% of patients, respectively. Some patients achieved clinical response only by the 25th week of treatment. The originally moderate RA activity and administration of methotrexate are the factors determining higher ETN effectivity in RA patients. The general tolerance of ETN was satisfactory; no uncommon adverse effects were observed.Conclusions. Analysis of the results of ETN therapy for 6 months attests to high effectiveness of this drug. Its advantages include the rapid clinical effect in most patients and good tolerance. ETN can be recommended for treatment of patients with moderate and severe RA when the conventional DMARDs therapy turns out to be insufficiently effective