Role of artrofoon in complex treatment of rheumatoid arthritis

Objective. To study influence of artrofoon on clinicolaboratory measures in pts with rheumatoid arthritis (RA). Material and methods. 119 RA pts (97 female, 22 male) were included. 104 of them were seropositive. Mean age was 52,3± 11,2 years, mean disease duration — 6,87+5,89 years. Disease activity level varied from 1 to 3 stage. Most pts had II or III radiological stage of RA. Usual clinical and laboratory examination of pts was performed at baseline and then after 1, 3, 6 and 12 months of treatment. Quantitative examination of serum cytokines was done using biochip technology method of Randox Laboratories Ltd (Great Britain). During the study all pts received standard treatment with disease modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs). The following NSAIDs were used: diclofenac in 54 pts (not more than 100 mg/day), nimesulid 200 mg/day in 37 pts, other NSAIDs - in 28 pts. The pts were divided into 2 groups. 91 pts of group 1 received artrofoon besides standard treatment. 28 pts of group 2 received only standard treatment. Results. Administration of artrofoon was accompanied by significant decrease of tumor necrosis factor a and interleukin (IL)ip levels after 3, 6 and 12 months of treatment, increase of IL4, IL10 and vascular endothelial growth factor to 6th month, decrease of epidermal growth factor to 12th month of treatment in comparison with control. These changes were accompanied by decrease of laboratory (ESR, CRP) and clinical measures of disease activity (VAS, Ritchie index, morning stiffness). Adverse events were absent in the main group of pts. Conclusion. Artrofoon exerted positive influence on the main clinicolaboratory and immunologic measures in pts with RA. Maximal effect was reached after 6 months of treatment. A part of pts decreased NSAID dose during treatment with artrofoon. The drug was well tolerated and safe during 12 months of treatment. Artrofoon can be administered with other drugs used in the treatment of RA

Variants of intensification of immunosuppressive therapy of rheumatoid arthritis

Objective. To assess influence of different treatment intensification regimens on clinico- laboratory parameters of activity and quality of life of pts with rheumatoid arthritis (RA). Material and methods. 40 RA pts of group 1 received pulse-therapy with methotrexate (MT) and dexamethasone (DM), 20ptsofgroup 2 received pulse-therapy with methylprednisolone (MP) and cyclophosphane (CP). After that all pts continued treatment with disease modifying antirheumatic drugs. Pts were examined at baseline, 1 and 6 months after completion of therapy intensification cycle. Results. At 1 month tender and swollen joint counts decrease in group 1 was more prominent than in group 2. After 6 months significant decrease of all disease activity measures was maintained in group 1 but not in pts received CP and MP. Conclusion. Pulse therapy with MT and DM provided more prolonged decrease of RA clinico-laboratory activity than treatment with MP and CP. Group 1 pts also showed significant increase of quality of life. None method of intensive treatment caused severe adverse events