Pub Date : 2024-02-16DOI: 10.14412/1996-7012-2024-1-7-14
A. Sukhinina, A. Lila, A. V. Smirnov, T. Korotaeva
Involvement of axial skeletal in psoriatic arthritis (PsA) is often associated with inflammatory changes in peripheral joints and is asymptomatic or minimally symptomatic, and changes in the spine and sacroiliac joints are often found only on X-ray. The article, which is based on numerous studies, compares the characteristics of axial skeletal lesions in patients with the axial form of psoriatic arthritis (axPsA) and in patients with ankylosing spondylitis and discusses the possibilities of their diagnosis using radiography and magnetic resonance imaging (MRI), including modern methods such as diffusion-weighted imaging, contrast-enhanced dynamic scanning and whole-body MRI.The main difficulty in diagnosing axPsA is that there is no universally accepted terminology or standardized diagnostic criteria, making it difficult to clearly distinguish axPsA from other forms of axial spondyloarthritis. Determining the first symptoms of axPsA not only helps to make a timely diagnosis and prescribe appropriate treatment, but also to monitor the activity of the disease and the dynamics of structural changes, which allows appropriate adjustment of the therapy needed to improve the quality of life of patients.
{"title":"Modern imaging techniques in the diagnosis of axial spondylitis: similarities and differences between axial psoriatic arthritis and ankylosing spondylitis","authors":"A. Sukhinina, A. Lila, A. V. Smirnov, T. Korotaeva","doi":"10.14412/1996-7012-2024-1-7-14","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-1-7-14","url":null,"abstract":"Involvement of axial skeletal in psoriatic arthritis (PsA) is often associated with inflammatory changes in peripheral joints and is asymptomatic or minimally symptomatic, and changes in the spine and sacroiliac joints are often found only on X-ray. The article, which is based on numerous studies, compares the characteristics of axial skeletal lesions in patients with the axial form of psoriatic arthritis (axPsA) and in patients with ankylosing spondylitis and discusses the possibilities of their diagnosis using radiography and magnetic resonance imaging (MRI), including modern methods such as diffusion-weighted imaging, contrast-enhanced dynamic scanning and whole-body MRI.The main difficulty in diagnosing axPsA is that there is no universally accepted terminology or standardized diagnostic criteria, making it difficult to clearly distinguish axPsA from other forms of axial spondyloarthritis. Determining the first symptoms of axPsA not only helps to make a timely diagnosis and prescribe appropriate treatment, but also to monitor the activity of the disease and the dynamics of structural changes, which allows appropriate adjustment of the therapy needed to improve the quality of life of patients.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"405 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-21DOI: 10.14412/1996-7012-2023-6-136-142
A. Lila, L. Alekseeva, I. Belyaeva, I. B. Vinogradova, N. A. Demidova, O. Kalyuzhin, I. I. Nesterovich, V. Sorotskaya, L. Y. Shirokova, S. Yakupova
On August 31,2023 in V.A. Nasonova Research Institute of Rheumatology a meeting of the Expert Council was held at which the principal investigators and co-investigators of the ARTNEO-2021 protocol "Multicenter randomized double-blind, placebo-controlled study of ARTNEO in patients with stage II-III primary knee osteoarthritis" was held. A consensus position was developed on the possibility and feasibility of using a combination of undenatured (native) type II collagen, methylsulfonylmethane, boswellic acids, vitamins C and D (ARTNEO complex) in clinical practice. Based on the results of the study, the use of the ARTNEO complex can be recommended as part of a complex therapy for patients with osteoarthritis as a course treatment with total duration up to 6 months. The results of the study can only be interpreted in relation to ARTNEO and cannot be transferred to preparations with a different composition.
{"title":"Resolution of the Council of Experts “Results of a multicenter, randomized, double-blind, placebo-controlled study of ARTNEO in patients with stage II–III primary knee osteoarthritis”","authors":"A. Lila, L. Alekseeva, I. Belyaeva, I. B. Vinogradova, N. A. Demidova, O. Kalyuzhin, I. I. Nesterovich, V. Sorotskaya, L. Y. Shirokova, S. Yakupova","doi":"10.14412/1996-7012-2023-6-136-142","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-136-142","url":null,"abstract":"On August 31,2023 in V.A. Nasonova Research Institute of Rheumatology a meeting of the Expert Council was held at which the principal investigators and co-investigators of the ARTNEO-2021 protocol \"Multicenter randomized double-blind, placebo-controlled study of ARTNEO in patients with stage II-III primary knee osteoarthritis\" was held. A consensus position was developed on the possibility and feasibility of using a combination of undenatured (native) type II collagen, methylsulfonylmethane, boswellic acids, vitamins C and D (ARTNEO complex) in clinical practice. Based on the results of the study, the use of the ARTNEO complex can be recommended as part of a complex therapy for patients with osteoarthritis as a course treatment with total duration up to 6 months. The results of the study can only be interpreted in relation to ARTNEO and cannot be transferred to preparations with a different composition.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"56 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.14412/1996-7012-2023-6-102-108
O. Georginova, N. N. Goncharova, E. A. Grishanina, S. A. Zakharova, E. A. Makarov, T. N. Krasnova
The article provides a description of the anthropological finding – human remains discovered in the church of St. Peter (Domashevo, Bosnia and Herzegovina, burial at the turn of the 15th and 16th centuries AD). The available morphological data most likely indicate the presence of diffuse idiopathic skeletal hyperostosis. This disease resulted in trauma to the cervical vertebrae, which altered their morphology. However, the injury did not lead to death; the person lived for a long time afterwards, as post-traumatic skeletal changes with the development of torticollis were noted.
{"title":"An example of a favorable outcome of a cervical spine injury occurring on a background of diffuse idiopathic skeletal hyperostosis: the result of an anthropological finding in the church of St. Peter in the town of Domashevo (Bosnia and Herzegovina)","authors":"O. Georginova, N. N. Goncharova, E. A. Grishanina, S. A. Zakharova, E. A. Makarov, T. N. Krasnova","doi":"10.14412/1996-7012-2023-6-102-108","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-102-108","url":null,"abstract":"The article provides a description of the anthropological finding – human remains discovered in the church of St. Peter (Domashevo, Bosnia and Herzegovina, burial at the turn of the 15th and 16th centuries AD). The available morphological data most likely indicate the presence of diffuse idiopathic skeletal hyperostosis. This disease resulted in trauma to the cervical vertebrae, which altered their morphology. However, the injury did not lead to death; the person lived for a long time afterwards, as post-traumatic skeletal changes with the development of torticollis were noted.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"34 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.14412/1996-7012-2023-6-92-101
B. D. Chaltsev, A. Torgashina, A. Lila, T. Markova, S. I. Kutsev, O. Ryzhkova, A. Orlova, A. Kokhno, T. I. Solovyova, V. Dvirnyk, A. Kovrigina, T. Obukhova, E. N. Parovichnikova, E. Nasonov
This article presents the first case of VEXAS syndrome identified in the Russian Federation as well as characteristics of currently known clinical manifestations and treatment approaches. The clinical observation described is an impressive example of how the identification of a new pathogenic mutation can change the understanding of the classification, diagnosis and treatment of previously known immunoinflammatory diseases. Thus, in refractory forms of relapsing polychondritis, neutrophilic dermatosis, atypical forms of vasculitis, inflammatory joint diseases or undifferentiated systemic inflammatory syndrome, especially when associated with macrocytic anemia and myelodysplastic syndrome, VEXAS syndrome should be suspected and genetic testing should be performed to exclude the autoinflammatory nature of the existing condition.
{"title":"EXAS syndrome: on the threshold of changing perceptions of known diseases","authors":"B. D. Chaltsev, A. Torgashina, A. Lila, T. Markova, S. I. Kutsev, O. Ryzhkova, A. Orlova, A. Kokhno, T. I. Solovyova, V. Dvirnyk, A. Kovrigina, T. Obukhova, E. N. Parovichnikova, E. Nasonov","doi":"10.14412/1996-7012-2023-6-92-101","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-92-101","url":null,"abstract":"This article presents the first case of VEXAS syndrome identified in the Russian Federation as well as characteristics of currently known clinical manifestations and treatment approaches. The clinical observation described is an impressive example of how the identification of a new pathogenic mutation can change the understanding of the classification, diagnosis and treatment of previously known immunoinflammatory diseases. Thus, in refractory forms of relapsing polychondritis, neutrophilic dermatosis, atypical forms of vasculitis, inflammatory joint diseases or undifferentiated systemic inflammatory syndrome, especially when associated with macrocytic anemia and myelodysplastic syndrome, VEXAS syndrome should be suspected and genetic testing should be performed to exclude the autoinflammatory nature of the existing condition.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"64 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.14412/1996-7012-2023-6-128-135
A. Karateev
Effective pain control is the most important clinical task in the treatment of osteoarthritis (OA). The International Expert Council, which discussed the possibility of introducing the principle of "treatment to target" to OA treatment, recognized the PASS (patient acceptable symptoms state) index as the most reasonable criterion for the successful treatment of this disease. However, according to several population studies, it is not possible to achieve a significant improvement in OA in 20–30% of patients. Factors that may be responsible for an inadequate response to the treatment of OA are severe structural changes in the joints, dysfunction of the nociceptive system (neuroplastic changes, central sensitization), psychoemotional disorders and comorbid pathologies. Therefore, the choice of therapeutic tactics in patients with OA who have moderate or severe pain should be individualized and take into account the phenotype of the disease, the characteristics of the clinical situation and the presence of comorbid pathologies. Leading experts in OA believe that the most rational approach to the management of this disease is a multidisciplinary, multimodal treatment that includes the complex use of nonsteroidal anti-inflammatory drugs, local injection therapy, Symptomatic Slow Acting Drugs for Osteoarthritis (SYSADOA) and non-pharmacological approaches. There is currently a strong evidence base confirming the efficacy and safety of SYSADOA (particularly the combination of glucosamine and chondroitin). This allows us to consider SYSADOA as a mandatory component of OA treatment, regardless of stage, phenotype and concomitant pathology. A new direction of OA therapy is the use of native (undenatured) collagen preparations, the effect of which is associated with the formation of immunological tolerance to autoantigens of this protein and a reduction in the severity of chronic joint inflammation. Several clinical studies have confirmed the effectiveness of native collagen supplements. The appearance of a new dietary supplement containing native collagen, glucosamine, chondroitin, B vitamins and ginger extract expands the possibilities of pharmaconutraceutical support for patients with OA.
有效控制疼痛是治疗骨关节炎（OA）最重要的临床任务。国际专家委员会在讨论将 "靶向治疗 "原则引入 OA 治疗的可能性时，认为 PASS（患者可接受的症状状态）指数是成功治疗该疾病的最合理标准。然而，根据多项人群研究发现，20%-30% 的患者无法获得明显的 OA 改善。导致 OA 治疗反应不充分的因素可能包括关节结构的严重变化、痛觉系统功能障碍（神经可塑性变化、中枢敏感化）、精神情绪障碍和合并病症。因此，对于有中度或重度疼痛的 OA 患者，治疗策略的选择应因人而异，并考虑到疾病的表型、临床情况的特点以及是否存在合并病症。OA 领域的权威专家认为，治疗这种疾病最合理的方法是多学科、多模式的治疗，包括非甾体抗炎药、局部注射疗法、骨关节炎症状慢作用药物（SYSADOA）和非药物疗法的综合使用。目前有大量证据证实了 SYSADOA（尤其是葡萄糖胺和软骨素的组合）的有效性和安全性。这使我们能够将 SYSADOA 作为治疗 OA 的必备成分，而不论其所处阶段、表型和伴随病理。治疗 OA 的一个新方向是使用原生（未变性）胶原蛋白制剂，其效果与形成对这种蛋白质自身抗原的免疫耐受和降低慢性关节炎症的严重程度有关。多项临床研究证实了原生胶原蛋白补充剂的有效性。一种含有原生胶原蛋白、氨基葡萄糖、软骨素、B 族维生素和生姜提取物的新型膳食补充剂的出现，扩大了为 OA 患者提供药物支持的可能性。
{"title":"Difficult-to-treat osteoarthritis – justification for multimodal treatment tactics","authors":"A. Karateev","doi":"10.14412/1996-7012-2023-6-128-135","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-128-135","url":null,"abstract":"Effective pain control is the most important clinical task in the treatment of osteoarthritis (OA). The International Expert Council, which discussed the possibility of introducing the principle of \"treatment to target\" to OA treatment, recognized the PASS (patient acceptable symptoms state) index as the most reasonable criterion for the successful treatment of this disease. However, according to several population studies, it is not possible to achieve a significant improvement in OA in 20–30% of patients. Factors that may be responsible for an inadequate response to the treatment of OA are severe structural changes in the joints, dysfunction of the nociceptive system (neuroplastic changes, central sensitization), psychoemotional disorders and comorbid pathologies. Therefore, the choice of therapeutic tactics in patients with OA who have moderate or severe pain should be individualized and take into account the phenotype of the disease, the characteristics of the clinical situation and the presence of comorbid pathologies. Leading experts in OA believe that the most rational approach to the management of this disease is a multidisciplinary, multimodal treatment that includes the complex use of nonsteroidal anti-inflammatory drugs, local injection therapy, Symptomatic Slow Acting Drugs for Osteoarthritis (SYSADOA) and non-pharmacological approaches. There is currently a strong evidence base confirming the efficacy and safety of SYSADOA (particularly the combination of glucosamine and chondroitin). This allows us to consider SYSADOA as a mandatory component of OA treatment, regardless of stage, phenotype and concomitant pathology. A new direction of OA therapy is the use of native (undenatured) collagen preparations, the effect of which is associated with the formation of immunological tolerance to autoantigens of this protein and a reduction in the severity of chronic joint inflammation. Several clinical studies have confirmed the effectiveness of native collagen supplements. The appearance of a new dietary supplement containing native collagen, glucosamine, chondroitin, B vitamins and ginger extract expands the possibilities of pharmaconutraceutical support for patients with OA.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139170842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.14412/1996-7012-2023-6-115-121
A. Karateev, A. Lila
Effective pain control is one of the main goals in the treatment of patient with musculoskeletal disorders. The main suffering of patients is associated with pain: decrease in working capacity and quality of life, disability and severe psycho-emotional disturbances. The pathogenesis of musculoskeletal pain is complex and includes damage (due to an autoimmune process, mechanical or metabolic stress), inflammation, peripheral and central sensitization, degenerative processes (neoangiogenesis, heterotopic ossification, fibrosis), muscle tension, psychoemotional disorders (depression, anxiety), negative behavioral reactions. Pain treatment should be comprehensive and include pharmacotherapy as well as non-pharmacological therapy and rehabilitation methods.Nonsteroidal anti-inflammatory drugs (NSAIDs) are at the forefront of pain treatment. They are effective, convenient and affordable, but can cause a wide range of complications. A personalized approach to pain management is therefore based on the choice of the “right” NSAID. Based on the balance between efficacy and safety, celecoxib can be considered the first choice. It has an extensive evidence base confirming its therapeutic potential in acute pain, osteoarthritis, chronic back pain, systemic rheumatic diseases and other pathologies, as well as a relatively low risk of gastrointestinal and cardiovascular complications. The prescription of celecoxib should be personalized: for severe pain and systemic rheumatic diseases, treatment should be started with a dose of 400 mg/day (600 mg can be used on the first day), followed by a transition to a maintenance dose of 200 mg/day once pain control is achieved.
{"title":"Differentiated approach to the treatment of musculoskeletal pain: higher doses of analgesics provide a better effect. A brief narrative review","authors":"A. Karateev, A. Lila","doi":"10.14412/1996-7012-2023-6-115-121","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-115-121","url":null,"abstract":"Effective pain control is one of the main goals in the treatment of patient with musculoskeletal disorders. The main suffering of patients is associated with pain: decrease in working capacity and quality of life, disability and severe psycho-emotional disturbances. The pathogenesis of musculoskeletal pain is complex and includes damage (due to an autoimmune process, mechanical or metabolic stress), inflammation, peripheral and central sensitization, degenerative processes (neoangiogenesis, heterotopic ossification, fibrosis), muscle tension, psychoemotional disorders (depression, anxiety), negative behavioral reactions. Pain treatment should be comprehensive and include pharmacotherapy as well as non-pharmacological therapy and rehabilitation methods.Nonsteroidal anti-inflammatory drugs (NSAIDs) are at the forefront of pain treatment. They are effective, convenient and affordable, but can cause a wide range of complications. A personalized approach to pain management is therefore based on the choice of the “right” NSAID. Based on the balance between efficacy and safety, celecoxib can be considered the first choice. It has an extensive evidence base confirming its therapeutic potential in acute pain, osteoarthritis, chronic back pain, systemic rheumatic diseases and other pathologies, as well as a relatively low risk of gastrointestinal and cardiovascular complications. The prescription of celecoxib should be personalized: for severe pain and systemic rheumatic diseases, treatment should be started with a dose of 400 mg/day (600 mg can be used on the first day), followed by a transition to a maintenance dose of 200 mg/day once pain control is achieved.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.14412/1996-7012-2023-6-122-127
O. N. Egorova, G. Tarasova, G. M. Koylubaeva, A. Bolotbekova, I. Guseva, T. Reshetnyak, A. Turatbekova, G. Suyunbai kyzy, A. O. Abdykerimov, A. A. Okunova
Large vessel vasculitis (LVV), including Takayasu's arteritis (AT, or non-specific aortoarteritis) and giant cell arteritis (GCA), is caused by granulomatous inflammation affecting mainly the aorta and its main branches. Damage to the vascular wall leads to ischemia of the corresponding organs and can be complicated by loss of vision, cerebral insufficiency and other life-threatening phenomena. The early diagnosis of these diseases in clinical practice is a difficult task that can only be solved by comparing the clinical symptoms, the results of the physical, laboratory and instrumental examination and the vascular biopsy.A comparative analysis of the 2018 and 2023 EULAR recommendations for imaging in LVV is presented. Duplex ultrasound (USDS) of not only temporal but also axillary arteries is recommended for GCA and magnetic resonance imaging (MRI) for AT. Alternative methods for GCA are MRI or positron emission tomography (PET) in combination with computed tomography (CT) and intravenous administration of fluorodeoxyglucose labelled with the short-lived fluoride isotope 18 (FDG-PET/CT), and for AT – FDG-PET/CT, CT or ultrasound examination. MRI, CT or ultrasound can be used for long-term monitoring of structural damage, especially to assess pre-existing vascular inflammation.
{"title":"New imaging strategy for large vessel vasculitis (based on the EULAR-2023 recommendations)","authors":"O. N. Egorova, G. Tarasova, G. M. Koylubaeva, A. Bolotbekova, I. Guseva, T. Reshetnyak, A. Turatbekova, G. Suyunbai kyzy, A. O. Abdykerimov, A. A. Okunova","doi":"10.14412/1996-7012-2023-6-122-127","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-122-127","url":null,"abstract":"Large vessel vasculitis (LVV), including Takayasu's arteritis (AT, or non-specific aortoarteritis) and giant cell arteritis (GCA), is caused by granulomatous inflammation affecting mainly the aorta and its main branches. Damage to the vascular wall leads to ischemia of the corresponding organs and can be complicated by loss of vision, cerebral insufficiency and other life-threatening phenomena. The early diagnosis of these diseases in clinical practice is a difficult task that can only be solved by comparing the clinical symptoms, the results of the physical, laboratory and instrumental examination and the vascular biopsy.A comparative analysis of the 2018 and 2023 EULAR recommendations for imaging in LVV is presented. Duplex ultrasound (USDS) of not only temporal but also axillary arteries is recommended for GCA and magnetic resonance imaging (MRI) for AT. Alternative methods for GCA are MRI or positron emission tomography (PET) in combination with computed tomography (CT) and intravenous administration of fluorodeoxyglucose labelled with the short-lived fluoride isotope 18 (FDG-PET/CT), and for AT – FDG-PET/CT, CT or ultrasound examination. MRI, CT or ultrasound can be used for long-term monitoring of structural damage, especially to assess pre-existing vascular inflammation.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"101 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138958767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.14412/1996-7012-2023-6-65-71
A. Karateev, E. Y. Polishchuk, H. R. Makhmudov, N. A. Bulgakova, E. Filatova, A. S. Potapova, V. Amirdzhanova, A. Lila
Dynamic monitoring of the patient's condition is a fundamental element of the modern strategy for the treatment of rheumatoid arthritis (RA), which aims to achieve remission or low inflammatory activity of the disease. A simple and informative indicator that can be used to assess treatment outcomes from a patient's perspective is the Patient Acceptable State Status (PASS).Objective: to determine the severity of patient-reported outcomes (PROs) and their relationship to the PASS indicator in patients with RA in reallife clinical practice.Material and methods. A one-time survey of 945 patients with RA was conducted in paper and electronic form from January to June 2023. The survey included the determination of PROs (pain, fatigue, anxiety, depression, activities of daily living, global assessment of health – GAH, – global assessment of disease activity – GADA) and PASS. The majority of patients were women – 87.8%, mean age – 46.3±13.2 years, median disease duration – 6 [3; 14] years. 80.4% of patients received synthetic disease modifying antirheumatic drugs, 23.9% – biologic disease modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi), 36.5% – glucocorticoids (GC), 82.8% – nonsteroidal anti-inflammatory drugs (NSAIDs).Results and discussion. According to the survey, the severity of joint pain (according to a numerical rating scale, NRS 0–10) was on average 5.3±2.6, fatigue – 6.2±2.6, GAH – 5.4±2.4, GADA – 5.4±2.7, median anxiety – 5 [3; 8], depression – 5 [2; 7], limitation of daily activity – 5 [3; 7]. Satisfaction with their health condition (PASS+) reported 54.8% of patients, dissatisfaction (PASS-) was associated with the presence of moderate/severe pain (NRS ≥4; odds ratio, OR 2.665; 95% confidence interval, CI 2.072–3.429; p<0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p><0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain; fatigue; depression; anxiety> ˂ 0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p<0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain
{"title":"How Russian patients with rheumatoid arthritis assess their condition: initial data from the OPTIMA (Patient Assessment of Severity, Outcomes and Medical Care in Arthritis) pilot study","authors":"A. Karateev, E. Y. Polishchuk, H. R. Makhmudov, N. A. Bulgakova, E. Filatova, A. S. Potapova, V. Amirdzhanova, A. Lila","doi":"10.14412/1996-7012-2023-6-65-71","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-65-71","url":null,"abstract":"Dynamic monitoring of the patient's condition is a fundamental element of the modern strategy for the treatment of rheumatoid arthritis (RA), which aims to achieve remission or low inflammatory activity of the disease. A simple and informative indicator that can be used to assess treatment outcomes from a patient's perspective is the Patient Acceptable State Status (PASS).Objective: to determine the severity of patient-reported outcomes (PROs) and their relationship to the PASS indicator in patients with RA in reallife clinical practice.Material and methods. A one-time survey of 945 patients with RA was conducted in paper and electronic form from January to June 2023. The survey included the determination of PROs (pain, fatigue, anxiety, depression, activities of daily living, global assessment of health – GAH, – global assessment of disease activity – GADA) and PASS. The majority of patients were women – 87.8%, mean age – 46.3±13.2 years, median disease duration – 6 [3; 14] years. 80.4% of patients received synthetic disease modifying antirheumatic drugs, 23.9% – biologic disease modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi), 36.5% – glucocorticoids (GC), 82.8% – nonsteroidal anti-inflammatory drugs (NSAIDs).Results and discussion. According to the survey, the severity of joint pain (according to a numerical rating scale, NRS 0–10) was on average 5.3±2.6, fatigue – 6.2±2.6, GAH – 5.4±2.4, GADA – 5.4±2.7, median anxiety – 5 [3; 8], depression – 5 [2; 7], limitation of daily activity – 5 [3; 7]. Satisfaction with their health condition (PASS+) reported 54.8% of patients, dissatisfaction (PASS-) was associated with the presence of moderate/severe pain (NRS ≥4; odds ratio, OR 2.665; 95% confidence interval, CI 2.072–3.429; p<0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p><0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain; fatigue; depression; anxiety> ˂ 0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p<0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.14412/1996-7012-2023-6-72-78
A. N. Kulikov, N. Muravyeva, B. Belov, G. Gridneva, E. Aronova
Objective: to study the efficacy and safety of the Gam-COVID-Vac vaccine in patients with immunoinflammatory rheumatic diseases (IRD) in a prospective study.Material and methods. The study included 42 patients with IRD and 57 individuals without IRD (control group) who received at least one component of Gam-COVID-Vac. Immunization with the first component of the vaccine was carried out from March 25th to August 1st, 2022, the second – 3 weeks after the first dose. On days 1, 3 and 7 after administration of the first and second components, the study participants provided information on adverse events (AEs) by telephone. All subjects were examined by a rheumatologist 1, 3 and 6 months after complete immunization. The observation period after immunization with the second dose was 6 months.Results and discussion. 42 patients received the first component of the vaccine, and 39 patients received two components. In the control group, 57 subjects were immunized with two components of the vaccine. 30–180 days after vaccination with two components of Gam-COVID-Vac, 3 (7.7%) patients were diagnosed with SARS-CoV-2 infection, which was confirmed by polymerase chain reaction. In all cases, a mild course of COVID-19 without signs of pneumonia was observed. There were no cases of COVID-19 in the control group. After immunization with the first component, a combination of at least one local and one systemic AE (SAE) was documented in 28.6% of patients with IRD and 33.3% of individuals in the control group (p>0.05). No AEs were recorded in 42.9% and 36.8% of cases respectively (p>0.05). After vaccination with the second component, a combination of ≥1 local AE and SAE was recorded in 15.4 % of patients with IRD and 22.8% of individuals in the control group (p>0.05). No AEs occurred in 71.8% and 56.1% of cases respectively (p>0.05). In 10.3% of patients with IRD and 12.3 % of those without IRD (p>0.05), a combination of local and systemic AEs was recorded after the introduction of both first and second components. No AEs were observed in 35.9% and 28.1% of cases, respectively (p>0.05). The overall rate of IRD exacerbations was 4.8%.Conclusion. Based on the available data, vaccination against COVID-19 appears to be effective and quite safe in patients with IRD.
{"title":"Efficacy and safety of the Gam-COVID-Vac in patients with immunoinflammatory rheumatic diseases: preliminary data of prospective study","authors":"A. N. Kulikov, N. Muravyeva, B. Belov, G. Gridneva, E. Aronova","doi":"10.14412/1996-7012-2023-6-72-78","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-72-78","url":null,"abstract":"Objective: to study the efficacy and safety of the Gam-COVID-Vac vaccine in patients with immunoinflammatory rheumatic diseases (IRD) in a prospective study.Material and methods. The study included 42 patients with IRD and 57 individuals without IRD (control group) who received at least one component of Gam-COVID-Vac. Immunization with the first component of the vaccine was carried out from March 25th to August 1st, 2022, the second – 3 weeks after the first dose. On days 1, 3 and 7 after administration of the first and second components, the study participants provided information on adverse events (AEs) by telephone. All subjects were examined by a rheumatologist 1, 3 and 6 months after complete immunization. The observation period after immunization with the second dose was 6 months.Results and discussion. 42 patients received the first component of the vaccine, and 39 patients received two components. In the control group, 57 subjects were immunized with two components of the vaccine. 30–180 days after vaccination with two components of Gam-COVID-Vac, 3 (7.7%) patients were diagnosed with SARS-CoV-2 infection, which was confirmed by polymerase chain reaction. In all cases, a mild course of COVID-19 without signs of pneumonia was observed. There were no cases of COVID-19 in the control group. After immunization with the first component, a combination of at least one local and one systemic AE (SAE) was documented in 28.6% of patients with IRD and 33.3% of individuals in the control group (p>0.05). No AEs were recorded in 42.9% and 36.8% of cases respectively (p>0.05). After vaccination with the second component, a combination of ≥1 local AE and SAE was recorded in 15.4 % of patients with IRD and 22.8% of individuals in the control group (p>0.05). No AEs occurred in 71.8% and 56.1% of cases respectively (p>0.05). In 10.3% of patients with IRD and 12.3 % of those without IRD (p>0.05), a combination of local and systemic AEs was recorded after the introduction of both first and second components. No AEs were observed in 35.9% and 28.1% of cases, respectively (p>0.05). The overall rate of IRD exacerbations was 4.8%.Conclusion. Based on the available data, vaccination against COVID-19 appears to be effective and quite safe in patients with IRD.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.14412/1996-7012-2023-6-84-91
P. Kovalenko, I. S. Dydykina, O. G. Alekseeva, E. L. Shakhramanova, A. S. Potapova, S. Glukhova, E. Zotkin
Ensuring a long-lasting effect of the therapy and its safety are important tasks in the treatment of patients with osteoarthritis (OA). Parenteral forms of chondroitin sulfate (CS) used for the background therapy of OA are characterized by proven efficacy and safety and, compared to oral forms, have greater bioavailability, faster onset of symptom-modifying effect and maintenance of more stable remission, which can significantly improve patients' quality of life.Objective: to evaluate the clinical efficacy and safety of two-month therapy with injectable CS and the duration of positive dynamics after the end of treatment in patients with knee OA (KOA).Material and methods. The open prospective observational study involved 35 patients (mainly women) aged 50–75 years with stage II–III KOA. All patients were prescribed intramuscular therapy with a CS solution (Mucosat® solution), with the first three injections of 1 ml, followed by 2 ml every second day (25 injections in total). Standard indices and questionnaires were used to assess the main clinical indicators at baseline and over time (14, 30, 60 days, 5 and 8 months after the start of treatment), as well as the results of ultrasound examination of the knee at baseline and at the end of treatment.Results and discussion. 14 days after the start of therapy, a statistically significant decrease in pain was observed applying the visual analogue scale (VAS), and after 2 months, 94% of patients had a significant decrease in knee pain according to VAS, Lequesne index and WOMAC index (total score and components). The KOOS parameters and quality of life according to EQ-5D-3L improved significantly. There was no pain or only minor pain (VAS ≤40 mm) in 54% of patients. The number of patients who had to take nonsteroidal anti-inflammatory drugs (NSAIDs) constantly fell threefold, while occasional use fell fivefold. The thickness of the synovial membrane of the knee joint and the number of patients with signs of synovitis decreased significantly. At 3 and 6 months after the end of therapy, most patients (60%) still had minor pain (≤40 mm according to VAS) and a significantly lower need for NSAIDs compared to baseline. The injectable CS was well tolerated and no adverse drug events were noted.Conclusion. We demonstrated both safety and efficacy and long-term maintenance of the clinical effect (6 months after the end of therapy) of injectable CS in the majority of OA patients, against the background of a low need for NSAIDs.
{"title":"Evaluation of the impact of a course of therapy with an injectable form of chondroitin sulfate on the duration of remission and quality of life in patients with osteoarthritis","authors":"P. Kovalenko, I. S. Dydykina, O. G. Alekseeva, E. L. Shakhramanova, A. S. Potapova, S. Glukhova, E. Zotkin","doi":"10.14412/1996-7012-2023-6-84-91","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-6-84-91","url":null,"abstract":"Ensuring a long-lasting effect of the therapy and its safety are important tasks in the treatment of patients with osteoarthritis (OA). Parenteral forms of chondroitin sulfate (CS) used for the background therapy of OA are characterized by proven efficacy and safety and, compared to oral forms, have greater bioavailability, faster onset of symptom-modifying effect and maintenance of more stable remission, which can significantly improve patients' quality of life.Objective: to evaluate the clinical efficacy and safety of two-month therapy with injectable CS and the duration of positive dynamics after the end of treatment in patients with knee OA (KOA).Material and methods. The open prospective observational study involved 35 patients (mainly women) aged 50–75 years with stage II–III KOA. All patients were prescribed intramuscular therapy with a CS solution (Mucosat® solution), with the first three injections of 1 ml, followed by 2 ml every second day (25 injections in total). Standard indices and questionnaires were used to assess the main clinical indicators at baseline and over time (14, 30, 60 days, 5 and 8 months after the start of treatment), as well as the results of ultrasound examination of the knee at baseline and at the end of treatment.Results and discussion. 14 days after the start of therapy, a statistically significant decrease in pain was observed applying the visual analogue scale (VAS), and after 2 months, 94% of patients had a significant decrease in knee pain according to VAS, Lequesne index and WOMAC index (total score and components). The KOOS parameters and quality of life according to EQ-5D-3L improved significantly. There was no pain or only minor pain (VAS ≤40 mm) in 54% of patients. The number of patients who had to take nonsteroidal anti-inflammatory drugs (NSAIDs) constantly fell threefold, while occasional use fell fivefold. The thickness of the synovial membrane of the knee joint and the number of patients with signs of synovitis decreased significantly. At 3 and 6 months after the end of therapy, most patients (60%) still had minor pain (≤40 mm according to VAS) and a significantly lower need for NSAIDs compared to baseline. The injectable CS was well tolerated and no adverse drug events were noted.Conclusion. We demonstrated both safety and efficacy and long-term maintenance of the clinical effect (6 months after the end of therapy) of injectable CS in the majority of OA patients, against the background of a low need for NSAIDs.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"117 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138959007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：