Objective: to study the course of COVID -19 and post-covid syndrome (PCS) in patients with rheumatoid arthritis (RA).Material and methods. The study included 32 adult patients with a confirmed diagnosis of RA, who met ACR/EULAR criteria. All patients had COVID-19. Material for analysis was obtained by means of a questionnaire developed at the V.A. Nasonova Research Institute of Rheumatology, which patients completed during their interview with the researcher.Results and discussion. The study group consisted mainly of women (n=29, 90%). The mean age of the patients was 50.75±16.48 years. Among the clinical manifestations of COVID-19, weakness/fatigue (90.6%; p<0.0001), fever (71.9%; p=0.0005) and anosmia (62.5%; p=0.045) were significantly more common. Almost half of the patients had dysgeusia (59.4%), increased arthralgia (53.1%), dyspnea on exertion (50%), and cough (46.9%). A significant positive association was found between increased arthralgia during COVID-19 and RA activity (r=0.72; p<0.05). Hospitalisation was required in 37.5% of patients with COVID-19. In 12.5% of cases, COVID-19 progressed with complications. Patients with higher RA activity were more likely to have an increase in arthralgia as a symptom of infection. PCS was registered in 47.8% of patients who underwent COVID-19. Retrospective evaluation of patients with PCS revealed a higher rate of hospitalisation in infectious disease departments and a more severe course of COVID-19. Subsequently, repeated cases of COVID-19 were more common in this group.Conclusion. Risk assessment of PCS development is necessary to appropriately distribute the burden on the health care system and to develop a strategy for prevention, timely diagnosis, and treatment of this syndrome in patients with rheumatic diseases. To achieve this goal, new studies in a larger cohort of patients with RA and rheumatic diseases in general are needed.
{"title":"COVID-19 and post-covid syndrome in patients with rheumatoid arthritis","authors":"Аронова Е.С, Белов Б.С, Гриднева Г.И, Фгбну «Научно-исследовательский, шоссе, 34А","doi":"10.14412/1996-7012-2023-4-71-74","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-71-74","url":null,"abstract":"Objective: to study the course of COVID -19 and post-covid syndrome (PCS) in patients with rheumatoid arthritis (RA).Material and methods. The study included 32 adult patients with a confirmed diagnosis of RA, who met ACR/EULAR criteria. All patients had COVID-19. Material for analysis was obtained by means of a questionnaire developed at the V.A. Nasonova Research Institute of Rheumatology, which patients completed during their interview with the researcher.Results and discussion. The study group consisted mainly of women (n=29, 90%). The mean age of the patients was 50.75±16.48 years. Among the clinical manifestations of COVID-19, weakness/fatigue (90.6%; p<0.0001), fever (71.9%; p=0.0005) and anosmia (62.5%; p=0.045) were significantly more common. Almost half of the patients had dysgeusia (59.4%), increased arthralgia (53.1%), dyspnea on exertion (50%), and cough (46.9%). A significant positive association was found between increased arthralgia during COVID-19 and RA activity (r=0.72; p<0.05). Hospitalisation was required in 37.5% of patients with COVID-19. In 12.5% of cases, COVID-19 progressed with complications. Patients with higher RA activity were more likely to have an increase in arthralgia as a symptom of infection. PCS was registered in 47.8% of patients who underwent COVID-19. Retrospective evaluation of patients with PCS revealed a higher rate of hospitalisation in infectious disease departments and a more severe course of COVID-19. Subsequently, repeated cases of COVID-19 were more common in this group.Conclusion. Risk assessment of PCS development is necessary to appropriately distribute the burden on the health care system and to develop a strategy for prevention, timely diagnosis, and treatment of this syndrome in patients with rheumatic diseases. To achieve this goal, new studies in a larger cohort of patients with RA and rheumatic diseases in general are needed.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73626743","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 : 2023-08-20DOI: 10.14412/1996-7012-2023-4-35-41
T. Y. Nuriahmetova, I. Valeeva, Y. Shevnina, A. Petrov, N. Cheremina, E. Sukhorukova, A. G. Vasiliev, D. Abdulganieva
In clinical practice, differences in the efficacy of tumor necrosis factor-α inhibitors (iTNF-α) have been observed in different diseases.Objective: to evaluate the efficacy of iTNF-α in patients with immune-mediated diseases and its relation to the immunogenicity of these drugs.Material and methods. The study included 70 patients with rheumatic diseases (RD) and 53 with inflammatory bowel disease (IBD) treated with infliximab (IFN), adalimumab, or certolizumab pegol (CZP). Disease activity and response to therapy were evaluated, as well as measurement of the minimal residual concentration of iTNF-α and the level of anti-drug antibodies.Results and discussion. Therapy efficacy was maintained in 60 (85.7%) patients with RD and 35 (66.0%) with IBD (odds ratio, OR 1.3; p=0.01). Event-free survival of therapy was observed more frequently in RD and was longer than in IBD (p<0.01). The incidence of treatment failure was 3.13 times higher in IBD than in RD (p<0.01). In contrast to IBD, low TNF-α levels were more common in RD patients who did not respond to treatment than in those who did (80% and 40%, respectively; OR 6.0; p<0.05). Anti-TNF-α antibodies were detected in 75% of patients with ineffective treatment with INF and CZP in the RD group and in 14.3% in the IBD group (OR 0.06; p<0.05).Conclusion. In patients with RD, the effect of iTNF-α lasted more frequently and longer than in patients with IBD. In ankylosing spondylitis and rheumatoid arthritis, the ineffectiveness of iTNF-α was associated with the formation of anti-drug antibodies or their low concentration in most cases, but in IBD only in half of the cases.
{"title":"Efficacy of tumor necrosis factor-α inhibitors in the treatment of various immunoinflammatory diseases: focus on immunogenicity","authors":"T. Y. Nuriahmetova, I. Valeeva, Y. Shevnina, A. Petrov, N. Cheremina, E. Sukhorukova, A. G. Vasiliev, D. Abdulganieva","doi":"10.14412/1996-7012-2023-4-35-41","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-35-41","url":null,"abstract":"In clinical practice, differences in the efficacy of tumor necrosis factor-α inhibitors (iTNF-α) have been observed in different diseases.Objective: to evaluate the efficacy of iTNF-α in patients with immune-mediated diseases and its relation to the immunogenicity of these drugs.Material and methods. The study included 70 patients with rheumatic diseases (RD) and 53 with inflammatory bowel disease (IBD) treated with infliximab (IFN), adalimumab, or certolizumab pegol (CZP). Disease activity and response to therapy were evaluated, as well as measurement of the minimal residual concentration of iTNF-α and the level of anti-drug antibodies.Results and discussion. Therapy efficacy was maintained in 60 (85.7%) patients with RD and 35 (66.0%) with IBD (odds ratio, OR 1.3; p=0.01). Event-free survival of therapy was observed more frequently in RD and was longer than in IBD (p<0.01). The incidence of treatment failure was 3.13 times higher in IBD than in RD (p<0.01). In contrast to IBD, low TNF-α levels were more common in RD patients who did not respond to treatment than in those who did (80% and 40%, respectively; OR 6.0; p<0.05). Anti-TNF-α antibodies were detected in 75% of patients with ineffective treatment with INF and CZP in the RD group and in 14.3% in the IBD group (OR 0.06; p<0.05).Conclusion. In patients with RD, the effect of iTNF-α lasted more frequently and longer than in patients with IBD. In ankylosing spondylitis and rheumatoid arthritis, the ineffectiveness of iTNF-α was associated with the formation of anti-drug antibodies or their low concentration in most cases, but in IBD only in half of the cases.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75462182","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 : 2023-08-20DOI: 10.14412/1996-7012-2023-4-64-70
M. Baranova, N. Muravyeva, B. Belov, T. Korotaeva, S. Glukhova
Objective: To investigate the frequency, structure, and risk factors of comorbid infections (CI) in patients with spondyloarthritis (SpA).Material and methods. The study included 332 patients with SpA. Patients were interviewed by the investigating physician, and additional information was obtained from medical records.Results and discussion. Respiratory tract (RT) and ear, nose, and throat (ENT) infections ranked first in the structure of CI. Exacerbation of SpA after CI was found in 42% of patients, and more severe CI against the background of SpA was found in 83 patients. 63 cases of severe CI (SCI) were documented, 63.5% of which were infections of the RT and ENT organs. Predictors for the development of lower RT (LRT) and ENT organ infections were the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in general (odds ratio, OR 2.018; 95% confidence interval, CI 1.221-3.335; p=0.006 and OR 1.761; 95% CI 1.1-2.819, respectively; p=0.018) and tumor necrosis factor-α (TNF-α) inhibitors in particular (OR 2.376; 95% CI 1.417-3.983; p=0.001 and OR 1.833; 95% CI 1.123-2.994; p=0.015), and disease duration of more than 5 years (OR 1.774; 95% CI 1.034—3.042; p=0.037 and OR 2.22; 95% CI 1.378-3.576; p=0.001). The risk of developing LRT infection was higher in the presence of chronic lung disease (OR 3.673; 95% CI 1.602-8.425; p=0.002) and Charlesson Comorbidity Index ≥1 (OR 2.381; 95% CI 1.439-3.94; p=0.001), risk of developing ENT organ infections - with the use of >1 bDMARD (OR 2.4; 95% CI 1.199-4.804; p=0.013) and duration of methotrexate therapy over 5 years (OR 2.478; 95% CI 1.053-5.831; p=0.038). Risk factors for the development of SCI were the use of bDMARDs in general (OR 1.941; 95% CI 1.063-3.545; p=0.031) and TNFα in particular (OR 2.246; 95%, CI 1.218-4.139; p=0.01).Conclusion. The problem of CI in SpA is of great importance. The vast majority of patients with SpA should be vaccinated against pneumococcal infection and influenza.
目的:探讨脊柱关节炎(SpA)患者共病感染(CI)的发生频率、结构及危险因素。材料和方法。该研究包括332例SpA患者。调查医生与患者进行了面谈，并从医疗记录中获得了更多信息。结果和讨论。呼吸道(RT)和耳鼻喉(ENT)感染在CI结构中排名第一。42%的患者CI后出现SpA加重，83例患者在SpA背景下出现更严重的CI。重度颅脑损伤(SCI) 63例，其中以RT、ENT器官感染为主，占63.5%。下RT (LRT)和耳鼻喉器官感染的预测因素是使用生物疾病改善抗风湿药物(bDMARDs)(优势比，OR 2.018;95%置信区间，CI 1.221 ~ 3.335;p=0.006, OR = 1.761;95% CI分别为1.1 ~ 2.819;p=0.018)，尤其是肿瘤坏死因子-α (TNF-α)抑制剂(OR 2.376;95% ci 1.417-3.983;p=0.001, OR为1.833;95% ci 1.123-2.994;p=0.015)，病程大于5年(OR 1.774;95% ci 1.034-3.042;p=0.037, OR = 2.22;95% ci 1.378-3.576;p = 0.001)。存在慢性肺部疾病的患者发生LRT感染的风险更高(OR 3.673;95% ci 1.602-8.425;p=0.002)， Charlesson合并症指数≥1 (OR 2.381;95% ci 1.439-3.94;p=0.001)，发生耳鼻喉器官感染的风险-使用>.1 bDMARD (OR 2.4;95% ci 1.199-4.804;p=0.013)和甲氨蝶呤治疗持续时间超过5年(OR 2.478;95% ci 1.053-5.831;p = 0.038)。发展为脊髓损伤的危险因素是一般使用bDMARDs (OR 1.941;95% ci 1.063-3.545;p=0.031)，尤其是TNFα (OR 2.246;95%， ci 1.218-4.139;.Conclusion p = 0.01)。SpA中的CI问题是一个非常重要的问题。绝大多数SpA患者应接种肺炎球菌感染和流感疫苗。
{"title":"Comorbid infections in patients with spondyloarthritis: frequency, structure and risk factors","authors":"M. Baranova, N. Muravyeva, B. Belov, T. Korotaeva, S. Glukhova","doi":"10.14412/1996-7012-2023-4-64-70","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-64-70","url":null,"abstract":"Objective: To investigate the frequency, structure, and risk factors of comorbid infections (CI) in patients with spondyloarthritis (SpA).Material and methods. The study included 332 patients with SpA. Patients were interviewed by the investigating physician, and additional information was obtained from medical records.Results and discussion. Respiratory tract (RT) and ear, nose, and throat (ENT) infections ranked first in the structure of CI. Exacerbation of SpA after CI was found in 42% of patients, and more severe CI against the background of SpA was found in 83 patients. 63 cases of severe CI (SCI) were documented, 63.5% of which were infections of the RT and ENT organs. Predictors for the development of lower RT (LRT) and ENT organ infections were the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in general (odds ratio, OR 2.018; 95% confidence interval, CI 1.221-3.335; p=0.006 and OR 1.761; 95% CI 1.1-2.819, respectively; p=0.018) and tumor necrosis factor-α (TNF-α) inhibitors in particular (OR 2.376; 95% CI 1.417-3.983; p=0.001 and OR 1.833; 95% CI 1.123-2.994; p=0.015), and disease duration of more than 5 years (OR 1.774; 95% CI 1.034—3.042; p=0.037 and OR 2.22; 95% CI 1.378-3.576; p=0.001). The risk of developing LRT infection was higher in the presence of chronic lung disease (OR 3.673; 95% CI 1.602-8.425; p=0.002) and Charlesson Comorbidity Index ≥1 (OR 2.381; 95% CI 1.439-3.94; p=0.001), risk of developing ENT organ infections - with the use of >1 bDMARD (OR 2.4; 95% CI 1.199-4.804; p=0.013) and duration of methotrexate therapy over 5 years (OR 2.478; 95% CI 1.053-5.831; p=0.038). Risk factors for the development of SCI were the use of bDMARDs in general (OR 1.941; 95% CI 1.063-3.545; p=0.031) and TNFα in particular (OR 2.246; 95%, CI 1.218-4.139; p=0.01).Conclusion. The problem of CI in SpA is of great importance. The vast majority of patients with SpA should be vaccinated against pneumococcal infection and influenza.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"188 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88142478","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 : 2023-08-18DOI: 10.14412/1996-7012-2023-4-120-137
A. Lila, N. Zagorodniy, A. Karateev, L. Alekseeva, N. Chichasova, G. Lazishvili, I. Akhtyamov, E. Bialik, M. Makarov, E. Taskina, E. I. Schmidt, V. Krylov, V. Bialik, V. Nesterenko
Local injection therapy (LIT) is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT. LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.
{"title":"Local injection therapy in the complex treatment of musculoskeletal disorders: principles of application, evidence base, safety","authors":"A. Lila, N. Zagorodniy, A. Karateev, L. Alekseeva, N. Chichasova, G. Lazishvili, I. Akhtyamov, E. Bialik, M. Makarov, E. Taskina, E. I. Schmidt, V. Krylov, V. Bialik, V. Nesterenko","doi":"10.14412/1996-7012-2023-4-120-137","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-120-137","url":null,"abstract":"Local injection therapy (LIT) is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT. LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76248131","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 : 2023-08-18DOI: 10.14412/1996-7012-2023-4-115-119
L. Alekseeva, O. Anoshenkova, N. G. Dolganova, E. Zholobova, E. Zonova, S. Lapshina, M. Korolev, L. Menshikova, P. Shesternya, Yu. P. Chasovskikh
At the meeting of the Expert Council on May 20, the safety of treatment for patients with osteoarthritis (OA), the most common form of joint disease, was discussed. The first step in the treatment of OA should be the administration of symptomatic delayed-acting agents (SYSADOA) and nonsteroidal anti-inflammatory drugs (NSAIDs). However, given the current understanding of the pathogenesis of inflammation, as well as the fact that it is an active process involving multiple proinflammatory and pro-resolving mediators, it is reasonable to limit the cyclooxygenase-2 suppressive treatment and to include medications with multipurpose effects that contribute to the resolution of inflammation, in particular Zeel® T and Traumeel® S. Traumeel® S affects all stages of inflammation, mostly on the pro-resolving mediators synthesis, and Zeel® T affects chondrogenesis, inflammation, metabolic processes in cartilage tissue and prevents angiogenesis.It was found that it is advisable to use Traumeel® S when it is not possible to prescribe systemic NSAIDs for pain relief. The combination of the proven therapeutic efficacy of Zeel® T and Traumeel® S with a minimal number of adverse events and the absence of interactions with other drugs allows them to be used as an independent treatment regimen for OA.
{"title":"Resolution of the Council of Experts of May 20, 2023 \"Issues of safety in the treatment of a rheumatological patient\"","authors":"L. Alekseeva, O. Anoshenkova, N. G. Dolganova, E. Zholobova, E. Zonova, S. Lapshina, M. Korolev, L. Menshikova, P. Shesternya, Yu. P. Chasovskikh","doi":"10.14412/1996-7012-2023-4-115-119","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-115-119","url":null,"abstract":"At the meeting of the Expert Council on May 20, the safety of treatment for patients with osteoarthritis (OA), the most common form of joint disease, was discussed. The first step in the treatment of OA should be the administration of symptomatic delayed-acting agents (SYSADOA) and nonsteroidal anti-inflammatory drugs (NSAIDs). However, given the current understanding of the pathogenesis of inflammation, as well as the fact that it is an active process involving multiple proinflammatory and pro-resolving mediators, it is reasonable to limit the cyclooxygenase-2 suppressive treatment and to include medications with multipurpose effects that contribute to the resolution of inflammation, in particular Zeel® T and Traumeel® S. Traumeel® S affects all stages of inflammation, mostly on the pro-resolving mediators synthesis, and Zeel® T affects chondrogenesis, inflammation, metabolic processes in cartilage tissue and prevents angiogenesis.It was found that it is advisable to use Traumeel® S when it is not possible to prescribe systemic NSAIDs for pain relief. The combination of the proven therapeutic efficacy of Zeel® T and Traumeel® S with a minimal number of adverse events and the absence of interactions with other drugs allows them to be used as an independent treatment regimen for OA.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86398848","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 : 2023-08-18DOI: 10.14412/1996-7012-2023-4-86-89
O. V. Alpidovskaya
We present a clinical observation of a patient whose cause of death was a new coronavirus infection COVID-19 complicated by bilateral viral interstitial pneumonia and adult acute respiratory distress syndrome. The presence of background diseases-rheumatoid arthritis and secondary AA-adrenal amyloidosis-worsened the prognosis. Waterhouse-Friderichsen syndrome with hemorrhage and foci of necrosis in the adrenal cortex developed against a background of SARS-CoV-2 infection. The unique feature of this case is the long-term favorable course of the disease and its rapid progression after infection with SARS-CoV-2. The associated syndrome of disseminated intravascular coagulation further aggravated the patient's condition.
{"title":"A clinical case of development of Waterhouse-Friderichsen syndrome after SARS-CoV-2 infection in a patient with rheumatoid arthritis and secondary adrenal AA-amyloidosis","authors":"O. V. Alpidovskaya","doi":"10.14412/1996-7012-2023-4-86-89","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-4-86-89","url":null,"abstract":"We present a clinical observation of a patient whose cause of death was a new coronavirus infection COVID-19 complicated by bilateral viral interstitial pneumonia and adult acute respiratory distress syndrome. The presence of background diseases-rheumatoid arthritis and secondary AA-adrenal amyloidosis-worsened the prognosis. Waterhouse-Friderichsen syndrome with hemorrhage and foci of necrosis in the adrenal cortex developed against a background of SARS-CoV-2 infection. The unique feature of this case is the long-term favorable course of the disease and its rapid progression after infection with SARS-CoV-2. The associated syndrome of disseminated intravascular coagulation further aggravated the patient's condition.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86146373","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 : 2023-07-13DOI: 10.14412/1996-7012-2023-3-89-95
E. Aronova, B. Belov, G. Gridneva
Glucocorticoids (GCs) are one of the most commonly used drugs for the treatment of rheumatoid arthritis (RA), the effectiveness of which is beyond doubt. The review considers current literature data on the safety of GCs use, as well as the most common adverse events associated with such therapy. Most authors point to an increased risk of complications with an increase in the daily dose and/or duration of GCs treatment. At the same time, a safe dose of GCs has not been determined. Probably, the optimal tactic is the selection of an individual dose of GCs in each individual case, taking into account the activity of RA and the spectrum of comorbid conditions. In this case, the minimum effective doses and short courses of GCs should be used, regular monitoring of clinical and laboratory parameters should be carried out in order to detect adverse events early.
{"title":"Revisiting the question of the safety of glucocorticoids use of in the treatment of rheumatoid arthritis","authors":"E. Aronova, B. Belov, G. Gridneva","doi":"10.14412/1996-7012-2023-3-89-95","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-3-89-95","url":null,"abstract":"Glucocorticoids (GCs) are one of the most commonly used drugs for the treatment of rheumatoid arthritis (RA), the effectiveness of which is beyond doubt. The review considers current literature data on the safety of GCs use, as well as the most common adverse events associated with such therapy. Most authors point to an increased risk of complications with an increase in the daily dose and/or duration of GCs treatment. At the same time, a safe dose of GCs has not been determined. Probably, the optimal tactic is the selection of an individual dose of GCs in each individual case, taking into account the activity of RA and the spectrum of comorbid conditions. In this case, the minimum effective doses and short courses of GCs should be used, regular monitoring of clinical and laboratory parameters should be carried out in order to detect adverse events early.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"177 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80678986","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 : 2023-07-13DOI: 10.14412/1996-7012-2023-3-111-120
A. Karateev, A. Lila, N. Zagorodniy, L. Alekseeva, S. Arkhipov, V. V. Arkov, M. S. Makarov, A. P. Rachin, V. Shirokov, M. N. Khokhlova, V. Nesterenko
Chronic shoulder pain (CSP) is a clinical syndrome associated with inflammatory and degenerative musculoskeletal changes, characterized by pain in the shoulder that persists for at least 3 months, arising or aggravated by functional activity in this area. The frequency of CSP in the modern population reaches 20–33%, it is one of the leading causes of severe suffering, disability and seeking for medical attention. The main causes of CSP are shoulder rotator impingement syndrome (subacromial impingement syndrome), calcific tendinitis, adhesive capsulitis, shoulder and acromioclavicular joint osteoarthritis. Accurate diagnosis of these diseases is necessary for the correct choice of treatment. Differential diagnosis is carried out using tests that evaluate the function of the shoulder joint and the rotator cuff muscles (Neer, Speed, Hawkins tests, etc.), as well as using instrumental methods (ultrasound, magnetic resonance tomography, X-ray). In CSP, it is necessary to exclude septic, oncological, visceral, systemic rheumatic and other diseases, as well as musculoskeletal pathology of the cervical spine, upper chest and back, which can cause pain in the shoulder region.Therapy for diseases that cause CSP should be personalized and complex, aimed at maximum pain control and restoration of function. For this purpose, non-steroidal anti-inflammatory drugs, local injection therapy with glucocorticoids, hyaluronic acid, and platelet-rich plasma are used. In some cases, muscle relaxants, antidepressants, anticonvulsants, local injections of botulinum toxin type A are indicated. Physiotherapy and medical rehabilitation methods play a fundamental role in the treatment of CSP.
{"title":"Council of Experts: chronic shoulder pain as a multidisciplinary problem","authors":"A. Karateev, A. Lila, N. Zagorodniy, L. Alekseeva, S. Arkhipov, V. V. Arkov, M. S. Makarov, A. P. Rachin, V. Shirokov, M. N. Khokhlova, V. Nesterenko","doi":"10.14412/1996-7012-2023-3-111-120","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-3-111-120","url":null,"abstract":"Chronic shoulder pain (CSP) is a clinical syndrome associated with inflammatory and degenerative musculoskeletal changes, characterized by pain in the shoulder that persists for at least 3 months, arising or aggravated by functional activity in this area. The frequency of CSP in the modern population reaches 20–33%, it is one of the leading causes of severe suffering, disability and seeking for medical attention. The main causes of CSP are shoulder rotator impingement syndrome (subacromial impingement syndrome), calcific tendinitis, adhesive capsulitis, shoulder and acromioclavicular joint osteoarthritis. Accurate diagnosis of these diseases is necessary for the correct choice of treatment. Differential diagnosis is carried out using tests that evaluate the function of the shoulder joint and the rotator cuff muscles (Neer, Speed, Hawkins tests, etc.), as well as using instrumental methods (ultrasound, magnetic resonance tomography, X-ray). In CSP, it is necessary to exclude septic, oncological, visceral, systemic rheumatic and other diseases, as well as musculoskeletal pathology of the cervical spine, upper chest and back, which can cause pain in the shoulder region.Therapy for diseases that cause CSP should be personalized and complex, aimed at maximum pain control and restoration of function. For this purpose, non-steroidal anti-inflammatory drugs, local injection therapy with glucocorticoids, hyaluronic acid, and platelet-rich plasma are used. In some cases, muscle relaxants, antidepressants, anticonvulsants, local injections of botulinum toxin type A are indicated. Physiotherapy and medical rehabilitation methods play a fundamental role in the treatment of CSP.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90567066","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 : 2023-07-13DOI: 10.14412/1996-7012-2023-3-82-88
A. O. Bobkova, A. Lila
The goal of treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity. A wide range of disease-modifying antirheumatic drugs is used for the treatment of RA, including biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi). However, even with the use of bDMARDs and JAKi, this goal can be achieved only in 40–60% of patients. Insufficient response to bDMARs and JAKi is the reason for switching to other drugs from the same group, such as tumor necrosis factor-α inhibitors, and to drugs with a different mechanism of action. The need to change therapy may be associated with its ineffectiveness due to various immune, genetic and epigenetic mechanisms, with the development of adverse reactions, as well as with comorbid pathology. To date, there is no certain predictors of effectiveness of a particular bDMARDs and JAKi and of the need and strategy for changing the therapy.The review considers the effectiveness of various classes of bDMARDs and JAKi in RA, the frequency and risk factors associated with the need to switch patients to other drugs, the role of chemokines as promising markers of response to RA treatment.
{"title":"Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis","authors":"A. O. Bobkova, A. Lila","doi":"10.14412/1996-7012-2023-3-82-88","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-3-82-88","url":null,"abstract":"The goal of treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity. A wide range of disease-modifying antirheumatic drugs is used for the treatment of RA, including biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi). However, even with the use of bDMARDs and JAKi, this goal can be achieved only in 40–60% of patients. Insufficient response to bDMARs and JAKi is the reason for switching to other drugs from the same group, such as tumor necrosis factor-α inhibitors, and to drugs with a different mechanism of action. The need to change therapy may be associated with its ineffectiveness due to various immune, genetic and epigenetic mechanisms, with the development of adverse reactions, as well as with comorbid pathology. To date, there is no certain predictors of effectiveness of a particular bDMARDs and JAKi and of the need and strategy for changing the therapy.The review considers the effectiveness of various classes of bDMARDs and JAKi in RA, the frequency and risk factors associated with the need to switch patients to other drugs, the role of chemokines as promising markers of response to RA treatment.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86342098","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 : 2023-07-13DOI: 10.14412/1996-7012-2023-3-96-103
A. Torgashina, A. Lila
The article discusses the relevance of determining DNA double-strand breaks (DSBs) using the analysis of γ-H2AX foci as a marker of DNA instability in various conditions. The issues of the formation of DSBs and the peculiarities of their detection in various tissues are highlighted. Changes in the intensity of DSBs formation during the use of radiological diagnostic methods, stress, increased physical exertion, some oncological and rheumatic diseases, as well as the dynamics of DNA repair on the background of various methods of therapy were analyzed.
{"title":"The potential use of DNA double-strand breaks detection in various fields of medicine","authors":"A. Torgashina, A. Lila","doi":"10.14412/1996-7012-2023-3-96-103","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-3-96-103","url":null,"abstract":"The article discusses the relevance of determining DNA double-strand breaks (DSBs) using the analysis of γ-H2AX foci as a marker of DNA instability in various conditions. The issues of the formation of DSBs and the peculiarities of their detection in various tissues are highlighted. Changes in the intensity of DSBs formation during the use of radiological diagnostic methods, stress, increased physical exertion, some oncological and rheumatic diseases, as well as the dynamics of DNA repair on the background of various methods of therapy were analyzed.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89553549","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}
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