Pub Date : 2024-03-01DOI: 10.47360/1995-4484-2024-109-117
A. Santimov, S. Grechanyi, G. A. Novik
The prevalence of concomitant mental disorders in children with rheumatic diseases is notably higher than in the overall population. However, psychiatric comorbidity in pediatric rheumatology remains poorly understood, whereas approaches to mental disorders therapy in children with rheumatic diseases are not clearly defined. The review article considers currently available data on the mental disorders prevaling in patients with juvenile idiopathic arthritis, juvenile-onset systemic lupus erythematosus and juvenile primary fibromyalgia. The article provides data on the efficacy and safety studies of psychotherapy and psychopharmacotherapy. It also discusses application prospects of biological disease-modifying antirheumatic drugs for treatment of comorbid depression in children with rheumatic diseases.
{"title":"Mental disorders in children with rheumatic diseases","authors":"A. Santimov, S. Grechanyi, G. A. Novik","doi":"10.47360/1995-4484-2024-109-117","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-109-117","url":null,"abstract":"The prevalence of concomitant mental disorders in children with rheumatic diseases is notably higher than in the overall population. However, psychiatric comorbidity in pediatric rheumatology remains poorly understood, whereas approaches to mental disorders therapy in children with rheumatic diseases are not clearly defined. The review article considers currently available data on the mental disorders prevaling in patients with juvenile idiopathic arthritis, juvenile-onset systemic lupus erythematosus and juvenile primary fibromyalgia. The article provides data on the efficacy and safety studies of psychotherapy and psychopharmacotherapy. It also discusses application prospects of biological disease-modifying antirheumatic drugs for treatment of comorbid depression in children with rheumatic diseases.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"112 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271095","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 : 2024-03-01DOI: 10.47360/1995-4484-2024-81-89
E. Gerasimova, T. Popkova, I. Kirillova, D. Gerasimova, E. Nasonov
The effect of an inhibitor of interleukin (IL) 6 receptors on the state of the cardiovascular system in patients with rheumatoid arthritis (RA) remains poorly understood, especially with its long-term use.The aim – to study the effect of therapy with the IL-6 receptor inhibitor tocilizumab (TCZ) on the dynamics of modifiable risk factors (RF), total cardiovascular risk (CVR), structural changes in the carotid arteries (CA) and the incidence of cardiovascular complications (CVC) in patients with rheumatoid arthritis during the 260-week follow-up period.Material and methods. The study included 37 patients with active RA (32 women and 5 men) with ineffectiveness and/or intolerance to disease modifying anti-rheumatic drugs (DMARDs); median age was 56 [48; 68] years, disease duration was 92 [49; 158] months; DAS28 (Disease Activity Score 28) – 6.2 [5.5; 6.7] points; all patients were seropositive for rheumatoid factor (RF), 86% – for antibodies to cyclic citrullinated peptide (ACCP). Patients received TCZ therapy 8 mg/kg intravenously every 4 weeks; after 192 [176; 210] weeks, 60% of patients switched to subcutaneous administration of the drug at a dose of 162 mg once a week. In 51% of patients with RA, TCZ monotherapy was performed, in 49% – combination therapy of TCZ with DMARDs. Statins were received by 17 (46%) patients, including 7 patients before and 10 after inclusion in the study. All patients underwent an assessment of traditional risk factors, the total cardiovascular risk was calculated using the mSCORE scale, atherosclerotic vascular lesions were assessed by the detection of atherosclerotic plaques (ASP) of CA. The observation period was 260.4 [251.5; 283.4] weeks.Results. After 260 weeks of TCZ therapy, RA remission was observed in 32 (86%) patients, low activity – in 5 (14%) patients. During the observation period, the frequency of modified RF and the total CVR did not change significantly, an increase in body mass index (BMI) by 11% was recorded, the number of patients with hypercholesterolemia and a reduced level of HDL cholesterol (C) decreased. In patients without statin therapy, there were no significant changes in the blood lipid spectrum. In the group of patients receiving statins, there was an increase in HDL-C by 43%, a decrease in cholesterol levels by 15%, atherogenic index (AI) by 56% (p<0.01 in all cases) and associations between the dynamics of ∆cholesterol and ∆CRP (r=0.35; p=0.04), ∆LDL-C and ∆CRP (r=0.41; p=0.03). Significant structural changes in CA in RA patients by the end of 260 weeks of TCZ therapy were not identified. Initially, intima-media thickness (IMT) CA positively moderately correlated with age (r=0.7; p<0.01), BMI (r=0.37; p<0.01), systolic blood pressure (SBP) (r=0.62; p<0.01) and weakly with lipid spectrum parameters – cholesterol (r=0.29; p<0.01), LDL-C (r=0.36; p<0.01). No new associations of IMT CA by the end of the observation, as well as the relationship of the IMT CA value with the indicators of RA
{"title":"Dynamics of modified cardiovascular risk factors in patients with rheumatoid arthritis on the background of 5-year therapy with an interleukin 6 receptor inhibitor","authors":"E. Gerasimova, T. Popkova, I. Kirillova, D. Gerasimova, E. Nasonov","doi":"10.47360/1995-4484-2024-81-89","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-81-89","url":null,"abstract":"The effect of an inhibitor of interleukin (IL) 6 receptors on the state of the cardiovascular system in patients with rheumatoid arthritis (RA) remains poorly understood, especially with its long-term use.The aim – to study the effect of therapy with the IL-6 receptor inhibitor tocilizumab (TCZ) on the dynamics of modifiable risk factors (RF), total cardiovascular risk (CVR), structural changes in the carotid arteries (CA) and the incidence of cardiovascular complications (CVC) in patients with rheumatoid arthritis during the 260-week follow-up period.Material and methods. The study included 37 patients with active RA (32 women and 5 men) with ineffectiveness and/or intolerance to disease modifying anti-rheumatic drugs (DMARDs); median age was 56 [48; 68] years, disease duration was 92 [49; 158] months; DAS28 (Disease Activity Score 28) – 6.2 [5.5; 6.7] points; all patients were seropositive for rheumatoid factor (RF), 86% – for antibodies to cyclic citrullinated peptide (ACCP). Patients received TCZ therapy 8 mg/kg intravenously every 4 weeks; after 192 [176; 210] weeks, 60% of patients switched to subcutaneous administration of the drug at a dose of 162 mg once a week. In 51% of patients with RA, TCZ monotherapy was performed, in 49% – combination therapy of TCZ with DMARDs. Statins were received by 17 (46%) patients, including 7 patients before and 10 after inclusion in the study. All patients underwent an assessment of traditional risk factors, the total cardiovascular risk was calculated using the mSCORE scale, atherosclerotic vascular lesions were assessed by the detection of atherosclerotic plaques (ASP) of CA. The observation period was 260.4 [251.5; 283.4] weeks.Results. After 260 weeks of TCZ therapy, RA remission was observed in 32 (86%) patients, low activity – in 5 (14%) patients. During the observation period, the frequency of modified RF and the total CVR did not change significantly, an increase in body mass index (BMI) by 11% was recorded, the number of patients with hypercholesterolemia and a reduced level of HDL cholesterol (C) decreased. In patients without statin therapy, there were no significant changes in the blood lipid spectrum. In the group of patients receiving statins, there was an increase in HDL-C by 43%, a decrease in cholesterol levels by 15%, atherogenic index (AI) by 56% (p<0.01 in all cases) and associations between the dynamics of ∆cholesterol and ∆CRP (r=0.35; p=0.04), ∆LDL-C and ∆CRP (r=0.41; p=0.03). Significant structural changes in CA in RA patients by the end of 260 weeks of TCZ therapy were not identified. Initially, intima-media thickness (IMT) CA positively moderately correlated with age (r=0.7; p<0.01), BMI (r=0.37; p<0.01), systolic blood pressure (SBP) (r=0.62; p<0.01) and weakly with lipid spectrum parameters – cholesterol (r=0.29; p<0.01), LDL-C (r=0.36; p<0.01). No new associations of IMT CA by the end of the observation, as well as the relationship of the IMT CA value with the indicators of RA ","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"8 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270070","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 : 2024-03-01DOI: 10.47360/1995-4484-2024-98-103
E. Loginova, P. Tremaskina, E. Gubar, T. Korotaeva, A. Sukhinina, S. Glukhova
Objective – to assess the dynamics of the sacroiliac joint radiographic progression (X-SIJ) in early psoriatic arthritis (ePsA).Methods. 32 patients (pts) (19 men and 13 women) with PsA were examined at baseline (BL) and after 7 years. Mean age – 43.9±12 years, Me PsA duration – 7.5 [6; 8.25] years, follow-up – 7 [5.75; 7.83] years. All patients received standard treatment using biologic therapy in 59.4% of cases, mainly with tumor necrosis factor α (TNF-α) inhibitors (43.7%). Radiographs of sacroiliac joint (SIJ) at BL and after 7 years were evaluated by an independent reader by Kellgren. Sacroiliitis (SI) on radiografhy (rSI) was recorded if there were changes in at least one SIJ grade II or higher. SI was considered radiologically significant (r-sSI) when it was bilateral grade II or higher, or unilateral grade III or IV. Progression was defined as the sift by ≥1 grade on any side.Results. At BL SI was not observed in 11 (34.3%) pts, SI grade I was present in 7 (21.9%) pts, grade II – in 10 (31.3%), grade III – in 4 (12.5%). After 7 years SI was not observed in 6 (18.75%) pts, SI grade I was present in 6 (18.75%) pts, grade II – in 8 (25%), grade III – in 8 (25%), grade IV – in 4 (12.5%). At BL rSI was registered in 14 (43.75%) patients, after 7 years the number of patients with rSI increased to 20 (62.5%). At BL and 7 years follow-up r-sSI was detected in 10 (31.3%) and 16 (50%) pts (p=0.128). On each side X-SIJ progression was detected in 15 (46.9%) pts (at 1 grade – in 10, 2 grades – in 1, 3 grades – in 4), 1 patient showed a decrease at 1 grade (from III to II).Conclusion. In ePsA radiographic progression of SI is slow. Dactylitis, high CRP, and lack of iTNF-α therapy are associated with radiographic progression.
目的--评估早期银屑病关节炎（ePsA）骶髂关节放射学进展（X-SIJ）的动态变化。32名PsA患者（pts）（19名男性和13名女性）在基线（BL）和7年后接受了检查。平均年龄（43.9±12）岁，PsA病程-7.5 [6; 8.25]年，随访-7 [5.75; 7.83]年。所有患者均接受了标准治疗，其中59.4%的病例使用了生物疗法，主要是肿瘤坏死因子α（TNF-α）抑制剂（43.7%）。骶髂关节（SIJ）在BL期和7年后的X光片由一名独立的Kellgren读片员进行评估。如果至少有一个骶髂关节出现二级或二级以上的变化，则记录为放射学上的骶髂关节炎（SI）（rSI）。当 SI 为双侧 II 级或以上，或单侧 III 级或 IV 级时，则被认为具有放射学意义（r-sSI）。任何一侧的SI≥1级即为进展。11 名患者（34.3%）在基础阶段未观察到 SI，7 名患者（21.9%）出现 I 级 SI，10 名患者（31.3%）出现 II 级 SI，4 名患者（12.5%）出现 III 级 SI。7 年后，6 名患者（18.75%）未观察到 SI，6 名患者（18.75%）出现 I 级 SI，8 名患者（25%）出现 II 级 SI，8 名患者（25%）出现 III 级 SI，4 名患者（12.5%）出现 IV 级 SI。有 14 名患者（43.75%）在基础阶段出现了 rSI，7 年后，出现 rSI 的患者增至 20 名（62.5%）。在 BL 和 7 年的随访中，分别有 10 名（31.3%）和 16 名（50%）患者检测到 r-SSI（P=0.128）。15例（46.9%）患者的两侧X-SIJ均有进展（10例为1级，1例为2级，4例为3级），1例患者的X-SIJ下降了1级（从III级降至II级）。在 ePsA 中，SI 的放射学进展缓慢。双下肢炎、高 CRP 和缺乏 iTNF-α 治疗与影像学进展有关。
{"title":"7 year of sacroiliac radiographic progression in early psoriatic arthritis (preliminary results)","authors":"E. Loginova, P. Tremaskina, E. Gubar, T. Korotaeva, A. Sukhinina, S. Glukhova","doi":"10.47360/1995-4484-2024-98-103","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-98-103","url":null,"abstract":"Objective – to assess the dynamics of the sacroiliac joint radiographic progression (X-SIJ) in early psoriatic arthritis (ePsA).Methods. 32 patients (pts) (19 men and 13 women) with PsA were examined at baseline (BL) and after 7 years. Mean age – 43.9±12 years, Me PsA duration – 7.5 [6; 8.25] years, follow-up – 7 [5.75; 7.83] years. All patients received standard treatment using biologic therapy in 59.4% of cases, mainly with tumor necrosis factor α (TNF-α) inhibitors (43.7%). Radiographs of sacroiliac joint (SIJ) at BL and after 7 years were evaluated by an independent reader by Kellgren. Sacroiliitis (SI) on radiografhy (rSI) was recorded if there were changes in at least one SIJ grade II or higher. SI was considered radiologically significant (r-sSI) when it was bilateral grade II or higher, or unilateral grade III or IV. Progression was defined as the sift by ≥1 grade on any side.Results. At BL SI was not observed in 11 (34.3%) pts, SI grade I was present in 7 (21.9%) pts, grade II – in 10 (31.3%), grade III – in 4 (12.5%). After 7 years SI was not observed in 6 (18.75%) pts, SI grade I was present in 6 (18.75%) pts, grade II – in 8 (25%), grade III – in 8 (25%), grade IV – in 4 (12.5%). At BL rSI was registered in 14 (43.75%) patients, after 7 years the number of patients with rSI increased to 20 (62.5%). At BL and 7 years follow-up r-sSI was detected in 10 (31.3%) and 16 (50%) pts (p=0.128). On each side X-SIJ progression was detected in 15 (46.9%) pts (at 1 grade – in 10, 2 grades – in 1, 3 grades – in 4), 1 patient showed a decrease at 1 grade (from III to II).Conclusion. In ePsA radiographic progression of SI is slow. Dactylitis, high CRP, and lack of iTNF-α therapy are associated with radiographic progression.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"293 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281392","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-65-80
E. L. Nasonov , V. I. Mazurov, A. Lila, T. Dubinina, I. Z. Gaydukova, S. A. Lapshina, A. Klimenko, D. V. Somov, S. A. Lukianov, D. M. Chudakov, I. Zvyagin, O. V. Britanova, M. A. Korolev, D. Abdulganieva, D. Krechikova, A. Kastanayan, L. V. Eliseeva, R. Samigullina, T. Povarova, O. Antipova, S. Smakotina, V. N. Soboleva, O. Nesmeyanova, T. Plaksina, N. Soroka, I. B. Vinogradova, A. Rebrov, T. Kropotina, A. L. Maslyanskiy, A. Zinkina-Orikhan, Yu. N. Lin’kova, P. S. Pukhtinskaia, M. A. Morozova, G. Vinderskaya
The aim – to evaluate the clinical effectiveness, safety, pharmacokinetics, pharmacodynamics, and immunogenicity of seniprutug (BCD-180) in patients with radiographic active axial spondyloarthritis (r-axSpA, or ankylosing spondylitis).Subjects and methods. 260 patients with active r-axSpA and inadequate response to nonsteroidal anti-inflammatory drugs (NSAIDs) were randomized into three groups: seniprutug (BCD-180) at doses of 5 mg/kg or 7 mg/kg, or placebo. BCD-180 was administered on weeks 0–12–36. Patients in the placebo group were switched to BCD-180 at a dose of 5 mg/kg at week 24 and continued therapy at week 36. The primary endpoint was the proportion of patients achieving 40% improvement by Assessment in Spondyloarthritis International Society scale (ASAS40) at week 24. Secondary endpoints were proportion achieving ASAS20/40, improvement of 5 out of 6 criteria of ASAS (ASAS5/6), ASAS partial remission, clinically important improvement in ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score with C-reactive protein) (ASDAS-CII) and major improvement in ASDAS-CRP (ASDAS-MI). The dynamics of the disease activity status according to ASDAS-CRP, the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and BASFI (Bath Ankylosing Spondylitis Functional Index) indices, as well as the dynamics of laboratory markers (C-reactive protein anderythrocyte sedimentation rate (ESR)) were analyzed. Safety was assessed by the frequency and profile of adverse events (AEs) and adverse reactions (ARs).Results. The proportion of patients achieving ASAS40 at week 24 with seniprutug (BCD-180) at the dose of 7 mg/kg and 5 mg/kg was 51.4% and 40.8%, respectively, compared with 24% in the placebo group (p=0.0012 and p=0.0417, respectively). Analysis of secondary endpoints showed that in patients with r-axSpA, BCD-180 at both study doses was significantly superior to placebo at week 24 in the following measures: decrease in the proportion of subjects with very high disease activity (ASDAS-CRP>3.5) achieving ASDAS-CII, ASAS20, ASAS5/6. A statistically significant decrease in the ASDAS-CRP, BASDAI, BASFI indices, as well as the concentration of CRP and ESR were demonstrated. Tolerability of seniprutug therapy was assessed as acceptable. Infusion reactions were the most common observed adverse events, the vast majority of which were mild to moderate in severity according to CTCAE 5.0 (Common Terminology Criteria for Adverse Events) and developed predominantly during the first administration. The proportion of patients with binding antibodies was 5.1%. However, no neutralizing antibodies were detected.Conclusion. Seniprutug (BCD-180) demonstrated superiority over placebo in clinical efficacy with a favorable safety profile and low immunogenicity as a treatment of r-axSpA.
{"title":"Effectiveness and safety of BCD180, anti-TRBV9+ T-lymphocytes monoclonal antibody in patients with active radiographic axial spondyloarthritis: 36-week results of double-blind randomized placebo-controlled phase II clinical study ELEFTA","authors":"E. L. Nasonov , V. I. Mazurov, A. Lila, T. Dubinina, I. Z. Gaydukova, S. A. Lapshina, A. Klimenko, D. V. Somov, S. A. Lukianov, D. M. Chudakov, I. Zvyagin, O. V. Britanova, M. A. Korolev, D. Abdulganieva, D. Krechikova, A. Kastanayan, L. V. Eliseeva, R. Samigullina, T. Povarova, O. Antipova, S. Smakotina, V. N. Soboleva, O. Nesmeyanova, T. Plaksina, N. Soroka, I. B. Vinogradova, A. Rebrov, T. Kropotina, A. L. Maslyanskiy, A. Zinkina-Orikhan, Yu. N. Lin’kova, P. S. Pukhtinskaia, M. A. Morozova, G. Vinderskaya","doi":"10.47360/1995-4484-2024-65-80","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-65-80","url":null,"abstract":"The aim – to evaluate the clinical effectiveness, safety, pharmacokinetics, pharmacodynamics, and immunogenicity of seniprutug (BCD-180) in patients with radiographic active axial spondyloarthritis (r-axSpA, or ankylosing spondylitis).Subjects and methods. 260 patients with active r-axSpA and inadequate response to nonsteroidal anti-inflammatory drugs (NSAIDs) were randomized into three groups: seniprutug (BCD-180) at doses of 5 mg/kg or 7 mg/kg, or placebo. BCD-180 was administered on weeks 0–12–36. Patients in the placebo group were switched to BCD-180 at a dose of 5 mg/kg at week 24 and continued therapy at week 36. The primary endpoint was the proportion of patients achieving 40% improvement by Assessment in Spondyloarthritis International Society scale (ASAS40) at week 24. Secondary endpoints were proportion achieving ASAS20/40, improvement of 5 out of 6 criteria of ASAS (ASAS5/6), ASAS partial remission, clinically important improvement in ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score with C-reactive protein) (ASDAS-CII) and major improvement in ASDAS-CRP (ASDAS-MI). The dynamics of the disease activity status according to ASDAS-CRP, the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and BASFI (Bath Ankylosing Spondylitis Functional Index) indices, as well as the dynamics of laboratory markers (C-reactive protein anderythrocyte sedimentation rate (ESR)) were analyzed. Safety was assessed by the frequency and profile of adverse events (AEs) and adverse reactions (ARs).Results. The proportion of patients achieving ASAS40 at week 24 with seniprutug (BCD-180) at the dose of 7 mg/kg and 5 mg/kg was 51.4% and 40.8%, respectively, compared with 24% in the placebo group (p=0.0012 and p=0.0417, respectively). Analysis of secondary endpoints showed that in patients with r-axSpA, BCD-180 at both study doses was significantly superior to placebo at week 24 in the following measures: decrease in the proportion of subjects with very high disease activity (ASDAS-CRP>3.5) achieving ASDAS-CII, ASAS20, ASAS5/6. A statistically significant decrease in the ASDAS-CRP, BASDAI, BASFI indices, as well as the concentration of CRP and ESR were demonstrated. Tolerability of seniprutug therapy was assessed as acceptable. Infusion reactions were the most common observed adverse events, the vast majority of which were mild to moderate in severity according to CTCAE 5.0 (Common Terminology Criteria for Adverse Events) and developed predominantly during the first administration. The proportion of patients with binding antibodies was 5.1%. However, no neutralizing antibodies were detected.Conclusion. Seniprutug (BCD-180) demonstrated superiority over placebo in clinical efficacy with a favorable safety profile and low immunogenicity as a treatment of r-axSpA.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"94 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408515","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-13-23
T. Reshetnyak, S. B. Kertchelaeva, N. Kosheleva
Maintaining and strengthening the health of the population is one of the primary functions of society. Inadequate understanding of the importance of contraception by the medical community and its application by society can lead to the population’s reproductive health becoming compromised. Basic knowledge of effective and safe contraceptive methods is important for every rheumatologist, as reproductive health affects both the general condition of patients and the course of the main rheumatic diseases (RH). This is particularly true for patients with antiphospholipid antibody (aPL) positivity, antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). The presence of aPL/APS, as well as the activity of SLE, are the main factors determining the choice of contraceptive method and the risk of hormonal contraception in patients with RH. Meanwhile, the use of appropriate (highly effective and safe) contraceptive therapy in this category of patients allows not only to plan the birth of a child, but also to avoid unwanted pregnancy in cases of disease activity, the use of embryotoxic and teratogenic drugs, as well as to carry out optimal treatment of concomitant pathology, which the supervising rheumatologist should be well aware of. This publication is devoted to the consideration of the main issues of contraception in the most “vulnerable” category of patients with RH – with positive aPL, APS and SLE.
{"title":"Contraception for antiphospholipid syndrome and systemic lupus erythematosus (according to the recommendations of the European Alliance of Associations for Rheumatology/American College of Rheumatology, EULAR/ACR)","authors":"T. Reshetnyak, S. B. Kertchelaeva, N. Kosheleva","doi":"10.47360/1995-4484-2024-13-23","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-13-23","url":null,"abstract":"Maintaining and strengthening the health of the population is one of the primary functions of society. Inadequate understanding of the importance of contraception by the medical community and its application by society can lead to the population’s reproductive health becoming compromised. Basic knowledge of effective and safe contraceptive methods is important for every rheumatologist, as reproductive health affects both the general condition of patients and the course of the main rheumatic diseases (RH). This is particularly true for patients with antiphospholipid antibody (aPL) positivity, antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). The presence of aPL/APS, as well as the activity of SLE, are the main factors determining the choice of contraceptive method and the risk of hormonal contraception in patients with RH. Meanwhile, the use of appropriate (highly effective and safe) contraceptive therapy in this category of patients allows not only to plan the birth of a child, but also to avoid unwanted pregnancy in cases of disease activity, the use of embryotoxic and teratogenic drugs, as well as to carry out optimal treatment of concomitant pathology, which the supervising rheumatologist should be well aware of. This publication is devoted to the consideration of the main issues of contraception in the most “vulnerable” category of patients with RH – with positive aPL, APS and SLE.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415135","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-55-64
S. Solovyev, N. Kozlovskaya, E. Aseeva, A. A. Baranov, N. Nikishina, E. Nasonov
Lupus nephritis (LN) is considered to be one of the most frequent severe manifestations of systemic lupus erythematosus (SLE), its various colonic manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and develop LN is considered one of the most important predictors of mortality in SLE. The structure of nephritis is dominated by diffuse proliferative LN with clinical and morphological signs of progression and the rapid development of terminal renal failure. SLE is diagnosed based on the 2019 EULAR/ACR (European Alliance of Associations for Rheumatology/American College of Rheumatology) diagnostic classification criteria. To confirm the diagnosis, evaluate the prognosis, and choose the tactics of treating the dis-ease, all patients in the absence of contraindications require a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy.
{"title":"Lupus nephritis – modern aspects of diagnosis and therapy. Part I","authors":"S. Solovyev, N. Kozlovskaya, E. Aseeva, A. A. Baranov, N. Nikishina, E. Nasonov","doi":"10.47360/1995-4484-2024-55-64","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-55-64","url":null,"abstract":"Lupus nephritis (LN) is considered to be one of the most frequent severe manifestations of systemic lupus erythematosus (SLE), its various colonic manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and develop LN is considered one of the most important predictors of mortality in SLE. The structure of nephritis is dominated by diffuse proliferative LN with clinical and morphological signs of progression and the rapid development of terminal renal failure. SLE is diagnosed based on the 2019 EULAR/ACR (European Alliance of Associations for Rheumatology/American College of Rheumatology) diagnostic classification criteria. To confirm the diagnosis, evaluate the prognosis, and choose the tactics of treating the dis-ease, all patients in the absence of contraindications require a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"650 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140417074","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-32-54
E. Nasonov
The pandemic of coronavirus disease 2019 (COVID-19), etiologically related to the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2), has drawn attention to new clinical and fundamental problems in the immunopathology of human diseases associated with virus-induced autoimmunity and autoinflammation. The provision that “the experience gained in rheumatology in the process of studying the pathogenetic mechanisms and pharmacotherapy of immunoinflammatory rheumatic diseases as the most common and severe forms of autoimmune and autoinflammatory pathology in humans will be in demand for deciphering the nature of the pathological processes underlying COVID-19 and developing approaches to effective pharmacotherapy” was confirmed in numerous studies conducted over the next 3 years in the midst of the COVID-19 pandemic. The main focus will be on a critical analysis of data regarding the role of autoimmune inflammation, which forms the basis of the pathogenesis of immune-mediated rheumatic diseases in the context of the immunopathology of COVID-19.
{"title":"Coronavirus disease 2019 (COVID-19) pandemic and autoimmune rheumatic diseases: Outcomes and prospects","authors":"E. Nasonov","doi":"10.47360/1995-4484-2024-32-54","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-32-54","url":null,"abstract":"The pandemic of coronavirus disease 2019 (COVID-19), etiologically related to the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2), has drawn attention to new clinical and fundamental problems in the immunopathology of human diseases associated with virus-induced autoimmunity and autoinflammation. The provision that “the experience gained in rheumatology in the process of studying the pathogenetic mechanisms and pharmacotherapy of immunoinflammatory rheumatic diseases as the most common and severe forms of autoimmune and autoinflammatory pathology in humans will be in demand for deciphering the nature of the pathological processes underlying COVID-19 and developing approaches to effective pharmacotherapy” was confirmed in numerous studies conducted over the next 3 years in the midst of the COVID-19 pandemic. The main focus will be on a critical analysis of data regarding the role of autoimmune inflammation, which forms the basis of the pathogenesis of immune-mediated rheumatic diseases in the context of the immunopathology of COVID-19.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411961","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-24-31
A. N. Kulikov, N. Muravyeva, B. Belov
The aim – to study risk factors for severe COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included medical histories of 464 patients with RD who were admitted at the V.A. Nasonova Research Institute of Rheumatology from September 27, 2021 to April 26, 2023Results. Age over 60 years, hypertension, obesity, lung disease, chronic kidney disease, coronary heart disease, diabetes mellitus, acute cerebrovascular accident or a history of pulmonary tuberculosis increase the risk of hospitalization in patients with RD with COVID-19 by 3–5 times. In addition, with an increase in the number of concomitant diseases, an increase in the risk of hospitalization was noted by 2–6 times. Taking glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, leads to an increase risk of hospitalization by 1.5–4.5 times, while patients taking hydroxychloroquine or tumor necrosis factor α inhibitors was more often required outpatient treatment.Conclusions. It has been established that older age, the presence of comorbid pathology and the use of glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, are risk factors for severe COVID-19.
{"title":"Risk factors for severe COVID-19 in patients with rheumatic diseases","authors":"A. N. Kulikov, N. Muravyeva, B. Belov","doi":"10.47360/1995-4484-2024-24-31","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-24-31","url":null,"abstract":"The aim – to study risk factors for severe COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included medical histories of 464 patients with RD who were admitted at the V.A. Nasonova Research Institute of Rheumatology from September 27, 2021 to April 26, 2023Results. Age over 60 years, hypertension, obesity, lung disease, chronic kidney disease, coronary heart disease, diabetes mellitus, acute cerebrovascular accident or a history of pulmonary tuberculosis increase the risk of hospitalization in patients with RD with COVID-19 by 3–5 times. In addition, with an increase in the number of concomitant diseases, an increase in the risk of hospitalization was noted by 2–6 times. Taking glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, leads to an increase risk of hospitalization by 1.5–4.5 times, while patients taking hydroxychloroquine or tumor necrosis factor α inhibitors was more often required outpatient treatment.Conclusions. It has been established that older age, the presence of comorbid pathology and the use of glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, are risk factors for severe COVID-19.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415853","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 : 2024-02-29DOI: 10.47360/1995-4484-2024-7-12
M. S. Eliseev, E. Nasonov
The possibilities for diagnosing and treating gout have expanded significantly. However, this did not lead to solving the problem of timely diagnosis of gout, nor to improving control over it, nor to reducing mortality in patients with gout. In the article possible reasons of absence of the progress in gout control connected with the lack of usage of contemporary capabilities in diagnosis and mistakes in usage of drugs therapy is discussed. These should include the lack of conversance of medical stuff about sonography high informativity for gout diagnosis, low availability of polarizing microscopy and dual energy computer tomography; causeless ignore of prescribing prophylactic symptomatic therapy, usage of inadequate doses of drugs. Another reason may be the absence of unified concept regarding specific indications of prescribing urate-lowering drugs and choice of specific medicine.
{"title":"Treatment and diagnostics of gout: Unsolved problems in clinical practice","authors":"M. S. Eliseev, E. Nasonov","doi":"10.47360/1995-4484-2024-7-12","DOIUrl":"https://doi.org/10.47360/1995-4484-2024-7-12","url":null,"abstract":"The possibilities for diagnosing and treating gout have expanded significantly. However, this did not lead to solving the problem of timely diagnosis of gout, nor to improving control over it, nor to reducing mortality in patients with gout. In the article possible reasons of absence of the progress in gout control connected with the lack of usage of contemporary capabilities in diagnosis and mistakes in usage of drugs therapy is discussed. These should include the lack of conversance of medical stuff about sonography high informativity for gout diagnosis, low availability of polarizing microscopy and dual energy computer tomography; causeless ignore of prescribing prophylactic symptomatic therapy, usage of inadequate doses of drugs. Another reason may be the absence of unified concept regarding specific indications of prescribing urate-lowering drugs and choice of specific medicine.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"2 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140409981","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 : 2024-01-01DOI: 10.47360/1995-4484-2023-689-699
A. A. Kolomeychuk
Idiopathic inflammatory myopathies (IIM) are a group of chronic autoimmune conditions characterized by proximal muscle weakness and potentially accompanied by a range of extramuscular clinical manifestations. There are subtypes of IIM including dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis (sIBM), overlap myositis (OM) with subgroup of anti-synthetase syndrome (ASS) and cancer-associated myositis. Taking into account rarity of the disease, heterogeneity of clinical presentation, difficulties in detection methods and interpretation of myositis associated autoantibodies (MAAs) and myositis specific autoantibodies (MSAs), search for objective imaging methods of muscle damage continues. This is important to definitive diagnosis, predicting subtypes of IIM and case follow-up. One of the most promising methods is magnetic resonance imaging (MRI). The aim of the review was to examine the role of MRI in assessment muscle damage, in particular, most typical MRI-findings and there features in different types of IIM with further clinical cases.
{"title":"Capabilities of magnetic resonance imaging in the diagnosis of idiopathic inflammatory myopathies","authors":"A. A. Kolomeychuk","doi":"10.47360/1995-4484-2023-689-699","DOIUrl":"https://doi.org/10.47360/1995-4484-2023-689-699","url":null,"abstract":"Idiopathic inflammatory myopathies (IIM) are a group of chronic autoimmune conditions characterized by proximal muscle weakness and potentially accompanied by a range of extramuscular clinical manifestations. There are subtypes of IIM including dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis (sIBM), overlap myositis (OM) with subgroup of anti-synthetase syndrome (ASS) and cancer-associated myositis. Taking into account rarity of the disease, heterogeneity of clinical presentation, difficulties in detection methods and interpretation of myositis associated autoantibodies (MAAs) and myositis specific autoantibodies (MSAs), search for objective imaging methods of muscle damage continues. This is important to definitive diagnosis, predicting subtypes of IIM and case follow-up. One of the most promising methods is magnetic resonance imaging (MRI). The aim of the review was to examine the role of MRI in assessment muscle damage, in particular, most typical MRI-findings and there features in different types of IIM with further clinical cases.","PeriodicalId":21518,"journal":{"name":"Rheumatology Science and Practice","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456901","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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