Pub Date : 2023-10-18DOI: 10.14412/1996-7012-2023-5-107-111
A. A. Shumilova, F. A. Cheldieva, K. S. Nurbaeva, T. A. Lisitsyna, L. M. Carter, E. M. Vital, T. M. Reshetnyak
Assessment of systemic lupus erythematosus (SLE) activity is important to determine the efficacy of treatment and to decide on further therapy. Russian-language versions of activity indices are needed to meet the needs of Russian-speaking patients and clinicians and to facilitate the use of these tools in clinical practice. An important step in this direction is the adaptation of the EASY-BILAG index, which is used to more accurately assess disease activity and select appropriate therapy in patients with SLE.
{"title":"Adaptation of the Russian version of the activity index of systemic lupus erythematosus EASY-BILAG","authors":"A. A. Shumilova, F. A. Cheldieva, K. S. Nurbaeva, T. A. Lisitsyna, L. M. Carter, E. M. Vital, T. M. Reshetnyak","doi":"10.14412/1996-7012-2023-5-107-111","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-107-111","url":null,"abstract":"Assessment of systemic lupus erythematosus (SLE) activity is important to determine the efficacy of treatment and to decide on further therapy. Russian-language versions of activity indices are needed to meet the needs of Russian-speaking patients and clinicians and to facilitate the use of these tools in clinical practice. An important step in this direction is the adaptation of the EASY-BILAG index, which is used to more accurately assess disease activity and select appropriate therapy in patients with SLE.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887931","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 : 2023-10-18DOI: 10.14412/1996-7012-2023-5-97-106
A. E. Karateev, E. Yu. Polishchuk, A. M. Lila, A. N. Ananyev, L. V. Ananyeva, A. V. Bondarev, A. A. Bondareva, A. R. Bukanbaeva, S. V. Vorster, S. A. Gadzhieva, D. G. Danilov, R. I. Eliseev, I. S. Zabelin, M. Yu. Ignatenko, I. V. Itkina, A. E. Kolesnikov, M. Yu. Konoplyanskaya, Yu. G. Krasnoyarova, S. I. Kukushkin, V. A. Lila, O. V. Makareva, V. S. Myagkikh, I. V. Nelgovskaya, N. V. Ocheredko, R. A. Panov, I. A. Polyakov, A. S. Prozorov, S. S. Rubina, M. E. Ryabochkina, M. A. Takhaev, E. R. Tokareva, T. V. Tolbina, M. I. Fominykh, V. V. Tsarev, E. I. Sharipova, M. V. Sheven, G. I. Shcherbakov, S. A. Yanchenkova
The combined use of drugs with different mechanisms of action is the main principle of musculoskeletal pain control in rheumatic diseases. However, there are few studies evaluating the efficacy of this approach in real practice.Objective: to determine the efficacy and safety of the combined use of celecoxib, diacerein, and the combination of glucosamine + chondroitin in osteoarthritis (OA) and chronic nonspecific low back pain (NSLBP). Material and methods. Statistical analysis of data obtained during a 3-month open observational study was performed. We included 1569 patients (63.6 % women and 36.4 % men, mean age 58.7 ± 11.0 years) with knee OA (kOA), hip OA (hOA), generalized OA (gOA), and chronic NSLBP with moderate/severe pain (≥ 4 on a numeric rating scale, NRS 0–10) who required nonsteroidal anti-inflammatory drugs. Celecoxib 200 mg twice daily was prescribed, with the dose reduced to 200 mg per day or taken “as needed" after significant pain relief; diacerein 50 mg twice daily; and a medication of glucosamine 250 mg and chondroitin 200 mg, 2 capsules 2–3 times daily. Outcomes were assessed after 3 months using the dynamics of pain, fatigue, dysfunction (according to NRS), and the “Patient Acceptable Symptom State” (PASS) indicator. Results and discussion. 80.2 % of patients completed the 3 month course of treatment, 4.4 % discontinued treatment due to adverse events (AEs), and for 15.4 % of patients there was no follow-up. After 3 months of treatment ≥ 50 % decrease (from baseline) in the severity of symptoms was noted in 83.4 % of patients for pain on movement, in 83.7 % for pain at rest, in 78.6 % for pain at night, in 80.8 % for dysfunction, and in 83.4 % for fatigue. 87.7 % of patients reported PASS. There were no significant differences in treatment outcomes for different localizations of OA and NSLBP: a ≥ 50 % pain reduction in kOA was achieved in 81.6 % of patients, in hOA – in 82.2 %, in gOA – in 85.0 %, in NSLBP – in 88.1 %. AEs were registered in 350 (22.4 %) patients, the most frequent was dyspepsia (n = 280, 17.8 %), diarrhea was recorded in 37 (2.4 %) cases. No serious AEs requiring hospitalization were registered. Conclusion. Combination therapy with celecoxib, diacerein, and a combination of glucosamine and chondroitin significantly reduces the severity of symptoms of OA and NSLBS.
{"title":"Efficacy and safety of the combined use of celecoxib, diacerein and a combination of glucosamine and chondroitin for the control of musculoskeletal pain associated with osteoarthritis and nonspecific back pain","authors":"A. E. Karateev, E. Yu. Polishchuk, A. M. Lila, A. N. Ananyev, L. V. Ananyeva, A. V. Bondarev, A. A. Bondareva, A. R. Bukanbaeva, S. V. Vorster, S. A. Gadzhieva, D. G. Danilov, R. I. Eliseev, I. S. Zabelin, M. Yu. Ignatenko, I. V. Itkina, A. E. Kolesnikov, M. Yu. Konoplyanskaya, Yu. G. Krasnoyarova, S. I. Kukushkin, V. A. Lila, O. V. Makareva, V. S. Myagkikh, I. V. Nelgovskaya, N. V. Ocheredko, R. A. Panov, I. A. Polyakov, A. S. Prozorov, S. S. Rubina, M. E. Ryabochkina, M. A. Takhaev, E. R. Tokareva, T. V. Tolbina, M. I. Fominykh, V. V. Tsarev, E. I. Sharipova, M. V. Sheven, G. I. Shcherbakov, S. A. Yanchenkova","doi":"10.14412/1996-7012-2023-5-97-106","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-97-106","url":null,"abstract":"The combined use of drugs with different mechanisms of action is the main principle of musculoskeletal pain control in rheumatic diseases. However, there are few studies evaluating the efficacy of this approach in real practice.Objective: to determine the efficacy and safety of the combined use of celecoxib, diacerein, and the combination of glucosamine + chondroitin in osteoarthritis (OA) and chronic nonspecific low back pain (NSLBP). Material and methods. Statistical analysis of data obtained during a 3-month open observational study was performed. We included 1569 patients (63.6 % women and 36.4 % men, mean age 58.7 ± 11.0 years) with knee OA (kOA), hip OA (hOA), generalized OA (gOA), and chronic NSLBP with moderate/severe pain (≥ 4 on a numeric rating scale, NRS 0–10) who required nonsteroidal anti-inflammatory drugs. Celecoxib 200 mg twice daily was prescribed, with the dose reduced to 200 mg per day or taken “as needed\" after significant pain relief; diacerein 50 mg twice daily; and a medication of glucosamine 250 mg and chondroitin 200 mg, 2 capsules 2–3 times daily. Outcomes were assessed after 3 months using the dynamics of pain, fatigue, dysfunction (according to NRS), and the “Patient Acceptable Symptom State” (PASS) indicator. Results and discussion. 80.2 % of patients completed the 3 month course of treatment, 4.4 % discontinued treatment due to adverse events (AEs), and for 15.4 % of patients there was no follow-up. After 3 months of treatment ≥ 50 % decrease (from baseline) in the severity of symptoms was noted in 83.4 % of patients for pain on movement, in 83.7 % for pain at rest, in 78.6 % for pain at night, in 80.8 % for dysfunction, and in 83.4 % for fatigue. 87.7 % of patients reported PASS. There were no significant differences in treatment outcomes for different localizations of OA and NSLBP: a ≥ 50 % pain reduction in kOA was achieved in 81.6 % of patients, in hOA – in 82.2 %, in gOA – in 85.0 %, in NSLBP – in 88.1 %. AEs were registered in 350 (22.4 %) patients, the most frequent was dyspepsia (n = 280, 17.8 %), diarrhea was recorded in 37 (2.4 %) cases. No serious AEs requiring hospitalization were registered. Conclusion. Combination therapy with celecoxib, diacerein, and a combination of glucosamine and chondroitin significantly reduces the severity of symptoms of OA and NSLBS.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135888380","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 : 2023-10-18DOI: 10.14412/1996-7012-2023-5-118-122
N. A. Konyshko, G. S. Konyshko
This review presents recent data on direct and indirect pathogenetic relationships between metabolism of purine compounds and biochemical processes in cells of the digestive system. A comprehensive analysis of available modern publications for the period from 2000 to 2022 in the Scopus, PubMed, eLIIBRARY, and Google Scholar databases was performed. The hypothesis linking the pathogenesis of hyperuricemia to “renal overload” suggests that the disease may develop due to impaired renal excretion with insufficient excretion of uric acid (UA) via the intestine. Some of the UA transport systems work actively in hepatocytes and enterocytes, which determines their formation and excretion. UA transporter proteins are divided into two categories: urate reabsorption transporters and urate excretion transporters; their expression is regulated by transcription factors, hormones, and metabolites of the intestinal microflora. The influence of intestinal microbiota on UA metabolism is associated with its involvement in purine metabolism, degradation and excretion of UA together with metabolites of intestinal flora, and suppression of gout inflammation, and is evaluated as a new therapeutic potential for gout and hyperuricemia to prevent renal damage and urolithiasis.
{"title":"Molecular mechanisms regulating uric acid metabolism in the human intestine, systematic literature review","authors":"N. A. Konyshko, G. S. Konyshko","doi":"10.14412/1996-7012-2023-5-118-122","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-118-122","url":null,"abstract":"This review presents recent data on direct and indirect pathogenetic relationships between metabolism of purine compounds and biochemical processes in cells of the digestive system. A comprehensive analysis of available modern publications for the period from 2000 to 2022 in the Scopus, PubMed, eLIIBRARY, and Google Scholar databases was performed. The hypothesis linking the pathogenesis of hyperuricemia to “renal overload” suggests that the disease may develop due to impaired renal excretion with insufficient excretion of uric acid (UA) via the intestine. Some of the UA transport systems work actively in hepatocytes and enterocytes, which determines their formation and excretion. UA transporter proteins are divided into two categories: urate reabsorption transporters and urate excretion transporters; their expression is regulated by transcription factors, hormones, and metabolites of the intestinal microflora. The influence of intestinal microbiota on UA metabolism is associated with its involvement in purine metabolism, degradation and excretion of UA together with metabolites of intestinal flora, and suppression of gout inflammation, and is evaluated as a new therapeutic potential for gout and hyperuricemia to prevent renal damage and urolithiasis.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135888746","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 : 2023-10-18DOI: 10.14412/1996-7012-2023-5-112-117
A. D. Koltakova, A. M. Lila
Checkpoint inhibitors (CPI) are anticancer drugs that activate the immune response against cancer cells. This type of treatment is highly effective, but also associates with many immunoinflammatory complications, including musculoskeletal. This review presents the current understanding of the clinical manifestations, pathogenesis and therapy of immune-mediated arthropathy in patients receiving CPI.
{"title":"Arthropathy associated with antitumor checkpoint inhibitors therapy: current understanding of the problem","authors":"A. D. Koltakova, A. M. Lila","doi":"10.14412/1996-7012-2023-5-112-117","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-112-117","url":null,"abstract":"Checkpoint inhibitors (CPI) are anticancer drugs that activate the immune response against cancer cells. This type of treatment is highly effective, but also associates with many immunoinflammatory complications, including musculoskeletal. This review presents the current understanding of the clinical manifestations, pathogenesis and therapy of immune-mediated arthropathy in patients receiving CPI.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887964","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 : 2023-10-18DOI: 10.14412/1996-7012-2023-5-123-131
V. I. Mazurov, A. M. Lila, L. I. Alekseeva, Ch. T. Baymukhamedov, B. G. Isaeva, D. A. Iskra, M. Yu. Karimov, H. T. Mirakhmedova, A. M. Mkrtumyan, D. A. Nabieva, A. V. Naumov, O. N. Tkacheva, E. A. Trofimov, M. N. Khokhlova
In recent decades, the prevalence of osteoarthritis (OA), one of the most disabling diseases, has increased worldwide, which imposes a significant burden on society. At the international multidisciplinary meeting, experts of various specialties (rheumatology, neurology, endocrinology, geriatrics, rehabilitation, traumatology and orthopedics) from Russia, Uzbekistan, and Kazakhstan discussed the importance of an individualized approach to the treatment of patients with OA, taking into account comorbidities, identified the most important and common clinical phenotypes of the disease, discussed known symptom- and structure-modifying effects of a combination of glucosamine and chondroitin sulfate, and new data on additional (pleiotropic) effects of these drugs that may have a positive impact on the course of comorbid diseases and conditions. The resolution of the Expert Council summarizes the results of the discussion and focuses on issues that are important for the further development of therapeutic approaches and recommendations for the management of such patients.
{"title":"Multimorbidity in osteoarthritis and pleiotropic effects of slow-acting symptomatic drugs. Resolution of the multidisciplinary International Expert Council","authors":"V. I. Mazurov, A. M. Lila, L. I. Alekseeva, Ch. T. Baymukhamedov, B. G. Isaeva, D. A. Iskra, M. Yu. Karimov, H. T. Mirakhmedova, A. M. Mkrtumyan, D. A. Nabieva, A. V. Naumov, O. N. Tkacheva, E. A. Trofimov, M. N. Khokhlova","doi":"10.14412/1996-7012-2023-5-123-131","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-123-131","url":null,"abstract":"In recent decades, the prevalence of osteoarthritis (OA), one of the most disabling diseases, has increased worldwide, which imposes a significant burden on society. At the international multidisciplinary meeting, experts of various specialties (rheumatology, neurology, endocrinology, geriatrics, rehabilitation, traumatology and orthopedics) from Russia, Uzbekistan, and Kazakhstan discussed the importance of an individualized approach to the treatment of patients with OA, taking into account comorbidities, identified the most important and common clinical phenotypes of the disease, discussed known symptom- and structure-modifying effects of a combination of glucosamine and chondroitin sulfate, and new data on additional (pleiotropic) effects of these drugs that may have a positive impact on the course of comorbid diseases and conditions. The resolution of the Expert Council summarizes the results of the discussion and focuses on issues that are important for the further development of therapeutic approaches and recommendations for the management of such patients.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135883810","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 : 2023-10-17DOI: 10.14412/1996-7012-2023-5-43-52
I. S. Dydykina, P. O. Postnikova, P. S. Kovalenko, S. I. Glukhova, A. M. Lila
Comorbid diseases and adverse events that occur in patients with rheumatoid arthritis (RA) negatively affect the outcomes of RA (radiological progression, joint function, the occurrence of low-energy fractures, thrombotic events, etc.). Objective: to study the structure of comorbid diseases and adverse events that occurred in patients with RA over the period of long-term prospective follow-up, to study the impact of these events on the dynamics of the functional status and working capacity of patients. Materials and methods. Аn open, cohort, prospective, long-term non-interventional study included 103 women with a definite diagnosis of RA (mean age 63.5 ± 8.3 years, follow-up period 8,5 ± 1,3 years). At baseline and in dynamics, standard laboratory and X-ray examinations were carried out. Results and discussion. There was a decrease in the DAS28 index and the number of patients with high or moderate activity [from 82 (85 %) to 67 (69 %), p = 0.02] against the background of an increase in the number of patients with remission or low activity [from 15 (15 %) to 30 (31 %), p = 0.012], at the same time there was an increase in the number of patients with ankylosis of joints [from 25 (24 %) to 41 (40 %), p = 0.017], functional class III [from 3 (3 %) to 15 (15 %), p=0.004], concomitant diseases [from 81 (79 %) to 94 (91 %), p = 0.015], thrombotic events [from 7 (7 %) to 18 (17 %), p = 0.027]. In 43 (42 %) patients 55 low-energy fractures were registered, in 24 (56 %) of them fractures occurred for the first time and in 19 (44 %) – repeatedly. Conclusion. As the prospective long-term follow-up shows, despite the decrease in RA activity, the number of patients with ankylosis, joint dysfunction and concomitant diseases increased. In the structure of concomitant diseases coronary heart disease and arterial hypertension dominated. A high incidence of thrombotic events, repeated and first-time low-energy fractures was noted. The number of disabled patients increased fivefold.
{"title":"Adverse events that occurred in patients with rheumatoid arthritis during long-term follow-up","authors":"I. S. Dydykina, P. O. Postnikova, P. S. Kovalenko, S. I. Glukhova, A. M. Lila","doi":"10.14412/1996-7012-2023-5-43-52","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-43-52","url":null,"abstract":"Comorbid diseases and adverse events that occur in patients with rheumatoid arthritis (RA) negatively affect the outcomes of RA (radiological progression, joint function, the occurrence of low-energy fractures, thrombotic events, etc.). Objective: to study the structure of comorbid diseases and adverse events that occurred in patients with RA over the period of long-term prospective follow-up, to study the impact of these events on the dynamics of the functional status and working capacity of patients. Materials and methods. Аn open, cohort, prospective, long-term non-interventional study included 103 women with a definite diagnosis of RA (mean age 63.5 ± 8.3 years, follow-up period 8,5 ± 1,3 years). At baseline and in dynamics, standard laboratory and X-ray examinations were carried out. Results and discussion. There was a decrease in the DAS28 index and the number of patients with high or moderate activity [from 82 (85 %) to 67 (69 %), p = 0.02] against the background of an increase in the number of patients with remission or low activity [from 15 (15 %) to 30 (31 %), p = 0.012], at the same time there was an increase in the number of patients with ankylosis of joints [from 25 (24 %) to 41 (40 %), p = 0.017], functional class III [from 3 (3 %) to 15 (15 %), p=0.004], concomitant diseases [from 81 (79 %) to 94 (91 %), p = 0.015], thrombotic events [from 7 (7 %) to 18 (17 %), p = 0.027]. In 43 (42 %) patients 55 low-energy fractures were registered, in 24 (56 %) of them fractures occurred for the first time and in 19 (44 %) – repeatedly. Conclusion. As the prospective long-term follow-up shows, despite the decrease in RA activity, the number of patients with ankylosis, joint dysfunction and concomitant diseases increased. In the structure of concomitant diseases coronary heart disease and arterial hypertension dominated. A high incidence of thrombotic events, repeated and first-time low-energy fractures was noted. The number of disabled patients increased fivefold.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136037482","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 : 2023-10-17DOI: 10.14412/1996-7012-2023-5-53-60
M. N. Starovoitova, O. V. Desinova, L. P. Ananyeva, O. A. Koneva, L. A. Garzanova, O. B. Ovsyannikova, R. U. Shayakhmetova
In systemic sclersis (SSc), different types of renal involvement occur. Their severity can range from asymptomatic deterioration of renal function to life-threatening damage, which is a complex therapeutic problem. Rituximab (RTM) has been used in the treatment of SSc and other autoimmune diseases with promising results, but its effect on renal function has not been adequately studied. Objective: to evaluate the renal function during complex therapy, including RTM, in patients with SSc over a long-term follow-up (at least 1 year). Material and methods. The study included 90 patients with SSc who were examined at least twice – before and 1–3.5 years after initiation of RTM treatment. Renal function was assessed by glomerular filtration rate (GFR) calculated according to the CKD-EPI formula. The stages of chronic kidney disease (CKD), blood pressure, daily proteinuria, skin score, activity, and indicators of lung function – forced vital capacity and diffusing capacity of the lungs – were also determined. Results and discussion. Against the background of complex therapy with RTM, there was a statistically significant decrease in GFR in the entire group of patients at the end of observation. On the other hand, renal function remained stable in the majority of patients with initially preserved GFR and there was a 25 % decrease – from 20 to 15 patients – in the number of patients with CKD. In more than half of the patients who initially had CKD, GFR increased (n = 11) or stabilized (n = 2) after therapy, and it decreased in a statistically insignificant manner in only 7 patients, whereas the development of a more advanced stage of CKD was observed in only 2 cases. The results of the treatment of 2 patients who had previously experienced scleroderma renal crisis (SRC) are reviewed in detail. Conclusion. In this study, there was no significant effect of RTM treatment on GFR and grade of CKD. Most patients had stable renal function; patients with an initial low grade of CKD showed a tendency toward stabilization of renal function. A significant decrease in GFR during long-term therapy noted in the entire patient group appears to be explained by an increase in renal insufficiency in patients with initially severe scleroderma renal damage, particularly due to SRC. Further studies on the effects of RTM therapy on renal function in patients with SSc are needed.
{"title":"Renal function during long-term therapy with rituximab in patients with systemic sclerosis","authors":"M. N. Starovoitova, O. V. Desinova, L. P. Ananyeva, O. A. Koneva, L. A. Garzanova, O. B. Ovsyannikova, R. U. Shayakhmetova","doi":"10.14412/1996-7012-2023-5-53-60","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-53-60","url":null,"abstract":"In systemic sclersis (SSc), different types of renal involvement occur. Their severity can range from asymptomatic deterioration of renal function to life-threatening damage, which is a complex therapeutic problem. Rituximab (RTM) has been used in the treatment of SSc and other autoimmune diseases with promising results, but its effect on renal function has not been adequately studied. Objective: to evaluate the renal function during complex therapy, including RTM, in patients with SSc over a long-term follow-up (at least 1 year). Material and methods. The study included 90 patients with SSc who were examined at least twice – before and 1–3.5 years after initiation of RTM treatment. Renal function was assessed by glomerular filtration rate (GFR) calculated according to the CKD-EPI formula. The stages of chronic kidney disease (CKD), blood pressure, daily proteinuria, skin score, activity, and indicators of lung function – forced vital capacity and diffusing capacity of the lungs – were also determined. Results and discussion. Against the background of complex therapy with RTM, there was a statistically significant decrease in GFR in the entire group of patients at the end of observation. On the other hand, renal function remained stable in the majority of patients with initially preserved GFR and there was a 25 % decrease – from 20 to 15 patients – in the number of patients with CKD. In more than half of the patients who initially had CKD, GFR increased (n = 11) or stabilized (n = 2) after therapy, and it decreased in a statistically insignificant manner in only 7 patients, whereas the development of a more advanced stage of CKD was observed in only 2 cases. The results of the treatment of 2 patients who had previously experienced scleroderma renal crisis (SRC) are reviewed in detail. Conclusion. In this study, there was no significant effect of RTM treatment on GFR and grade of CKD. Most patients had stable renal function; patients with an initial low grade of CKD showed a tendency toward stabilization of renal function. A significant decrease in GFR during long-term therapy noted in the entire patient group appears to be explained by an increase in renal insufficiency in patients with initially severe scleroderma renal damage, particularly due to SRC. Further studies on the effects of RTM therapy on renal function in patients with SSc are needed.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038396","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 : 2023-10-17DOI: 10.14412/1996-7012-2023-5-87-91
M. S. Eliseev, E. V. Panina, O. V. Zheliabina
Hyperuricemia (HU) is a condition caused by an increase in serum uric acid (UA) levels above 360 μmol/l. Often HU is asymptomatic, but under the influence of genetic and environmental factors, attacks of peripheral arthritis (gout) may occur. Remission of gout is achieved by normalization of UA serum levels, which can be determined by a colorimetric or electrochemical method, although the latter is not currently commonly used in clinical practice to control UA levels. Objective: to compare the standard colorimetric and electrochemical methods (Easy Touch GCU Meter) for monitoring UA levels. Material and methods. 30 gout patients were included in the study. This group included subjects with current/anamnestic asymptomatic HU andpatients with a confirmed diagnosis of gout (ACR/EULAR 2015 criteria). The examination included a general examination, history taking, and laboratory testing. The determination of UA level by the colorimetric method in venous blood serum was performed no later than 5 minutes after collection, and the determination of UA level in fresh whole capillary blood from the fingertip by the electrochemical method (Easy Touch GCU Meter) – immediately after collection. Results and discussion. The average values of UA blood level determined by the two compared methods differed by 13.9 μmol/l (3.9 % with respect to the colorimetric method). The high value of the correlation coefficient (r = 0.86) indicates a close linear relationship between the compared results and their good agreement. The method is also applicable in patients with achieved normouricemia. Conclusions. The method of electrochemical determination of UA level in subjects with HU and gout can be used in real clinical practice for self-monitoring.
{"title":"Comparison of colorimetric and electrochemical (Easy Touch GCU Meter) methods for determination of blood uric acid in clinical practice in patients with gout and hyperuricemia (data from a pilot study)","authors":"M. S. Eliseev, E. V. Panina, O. V. Zheliabina","doi":"10.14412/1996-7012-2023-5-87-91","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-87-91","url":null,"abstract":"Hyperuricemia (HU) is a condition caused by an increase in serum uric acid (UA) levels above 360 μmol/l. Often HU is asymptomatic, but under the influence of genetic and environmental factors, attacks of peripheral arthritis (gout) may occur. Remission of gout is achieved by normalization of UA serum levels, which can be determined by a colorimetric or electrochemical method, although the latter is not currently commonly used in clinical practice to control UA levels. Objective: to compare the standard colorimetric and electrochemical methods (Easy Touch GCU Meter) for monitoring UA levels. Material and methods. 30 gout patients were included in the study. This group included subjects with current/anamnestic asymptomatic HU andpatients with a confirmed diagnosis of gout (ACR/EULAR 2015 criteria). The examination included a general examination, history taking, and laboratory testing. The determination of UA level by the colorimetric method in venous blood serum was performed no later than 5 minutes after collection, and the determination of UA level in fresh whole capillary blood from the fingertip by the electrochemical method (Easy Touch GCU Meter) – immediately after collection. Results and discussion. The average values of UA blood level determined by the two compared methods differed by 13.9 μmol/l (3.9 % with respect to the colorimetric method). The high value of the correlation coefficient (r = 0.86) indicates a close linear relationship between the compared results and their good agreement. The method is also applicable in patients with achieved normouricemia. Conclusions. The method of electrochemical determination of UA level in subjects with HU and gout can be used in real clinical practice for self-monitoring.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"278 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136037633","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 : 2023-10-17DOI: 10.14412/1996-7012-2023-5-67-72
G. I. Gridneva, E. S. Aronova, B. S. Belov
Objective: to evaluate the completeness of screening for hepatitis B virus (HBV) infection in HBsAg-positive patients admitted to a rheumatology hospital and to follow the history of HBV reactivation/seroversion during antirheumatic therapy. Material and methods. The results of initial and repeated (if applicable) hospitalizations were analyzed in 80 patients with rheumatic diseases (RD), including 55 (69%) women and 25 (31 %) men, with Australian surface antigen (HBsAg), admitted to the V.A. Nasonova Institute of Rheumatology from January 1, 2020 to July 20, 2022 (30 months). Results and discussion. The total number of hospitalizations to the clinic during the observation period, including repeat admissions, was 13,681. The number of hospitalizations in 80 patients with HBV infection during the observation period, including repeat admissions, was 144, of which for systemic vasculitis – 6 (8 %), other systemic connective tissue diseases – 16 (20 %), osteoarthritis and post-traumatic changes of joints – 14 (15 %), inflammatory joint diseases – 42 (54 %). Cases of HBV reactivation/seroverion, both in anamnesis and during observation, were detected in 9 (11 %) patients, and most frequently (n = 5) they were registered during methotrexate therapy. Conclusion. HBV infection in patients with RD leads to significant difficulties in the selection of drug therapy, due to the risk of reactivation of the infection. The results obtained indicate incomplete screening of patients with RD for HBV infection during the preclinical phase. Further investigation is needed to develop clear recommendations for the management of patients with RD infected with HBV.
目的:评价某风湿病医院收治的hbsag阳性患者乙型肝炎病毒(HBV)感染筛查的完整性，并在抗风湿病治疗期间跟踪HBV再激活/血清逆转史。材料和方法。本研究分析了2020年1月1日至2022年7月20日(30个月)在va Nasonova风湿病研究所(va Nasonova Institute of Rheumatology)首次和重复(如果适用)住院治疗的80例风湿病(RD)患者的结果，其中55例(69%)女性和25例(31%)男性携带澳大利亚表面抗原(HBsAg)。结果和讨论。在观察期间，到该诊所住院的总人数为13 681人，包括重复入院。在观察期间，80例HBV感染患者(包括重复入院)的住院人数为144人，其中全身性血管炎6人(8%)，其他全身性结缔组织疾病16人(20%)，骨关节炎和关节创伤后改变14人(15%)，炎症性关节疾病42人(54%)。9例(11%)患者在记忆和观察期间检测到HBV再激活/血清浓度升高，其中最常见的(n = 5)是在甲氨蝶呤治疗期间登记的。结论。由于感染再次激活的风险，RD患者的HBV感染导致了药物治疗选择的重大困难。获得的结果表明，在临床前阶段，RD患者的HBV感染筛查不完全。需要进一步的研究来制定明确的建议，以管理RD感染HBV的患者。
{"title":"Chronic hepatitis B in hospitalized rheumatologic patients: problems of screening and reactivation of infection","authors":"G. I. Gridneva, E. S. Aronova, B. S. Belov","doi":"10.14412/1996-7012-2023-5-67-72","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-67-72","url":null,"abstract":"Objective: to evaluate the completeness of screening for hepatitis B virus (HBV) infection in HBsAg-positive patients admitted to a rheumatology hospital and to follow the history of HBV reactivation/seroversion during antirheumatic therapy. Material and methods. The results of initial and repeated (if applicable) hospitalizations were analyzed in 80 patients with rheumatic diseases (RD), including 55 (69%) women and 25 (31 %) men, with Australian surface antigen (HBsAg), admitted to the V.A. Nasonova Institute of Rheumatology from January 1, 2020 to July 20, 2022 (30 months). Results and discussion. The total number of hospitalizations to the clinic during the observation period, including repeat admissions, was 13,681. The number of hospitalizations in 80 patients with HBV infection during the observation period, including repeat admissions, was 144, of which for systemic vasculitis – 6 (8 %), other systemic connective tissue diseases – 16 (20 %), osteoarthritis and post-traumatic changes of joints – 14 (15 %), inflammatory joint diseases – 42 (54 %). Cases of HBV reactivation/seroverion, both in anamnesis and during observation, were detected in 9 (11 %) patients, and most frequently (n = 5) they were registered during methotrexate therapy. Conclusion. HBV infection in patients with RD leads to significant difficulties in the selection of drug therapy, due to the risk of reactivation of the infection. The results obtained indicate incomplete screening of patients with RD for HBV infection during the preclinical phase. Further investigation is needed to develop clear recommendations for the management of patients with RD infected with HBV.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038525","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 : 2023-10-17DOI: 10.14412/1996-7012-2023-5-92-96
R. I. Sadykov, I. F. Akhtyamov, K. T. Shoshorina, S. A. Lapshina
Ankle capsular ligamentous apparatus damage is one of the most common problems. Ankle injuries account for one-fifth of all lower extremity sports injuries. More than 81 % of acute ankle injuries are treated conservatively, with the rate of unsatisfactory results after this treatment ranging from 2 to 36.9 %. Objective: to evaluate the efficacy and safety of the combined use of aceclofenac (Airtal) and tolperisone (Mydocalm Long) in patients with acute ankle ligament injuries. Material and methods. Sixty patients aged 18 to 65 years with acute ankle ligament injury of grade II according to Kannus and Renstrom, with pain intensity in the joint on a visual analogue scale (VAS) ≥ 50 mm, who had no contraindications for the use of these drugs, participated in the study. Patients in the main group (n = 30) received aceclofenac 100 mg in powder form 2 times daily and tolperisone 450 mg in tablets once daily for 14 days. Patients in the comparison group (n = 30) received only aceclofenac 100 mg in powder form 2 times daily for 14 days. The efficacy of therapy was assessed by pain dynamics according to VAS and functional abilities according to the Foot and Ankle Ability Measure (FAAM) questionnaire, which included the Activities of Daily Living (ADL) subscale and the Sports subscale. To assess safety, laboratory tests were performed at visits 1 and 4, and adverse events (AEs) were assessed at visits 2, 3, and 4. Results and discussion. Combined use of aceclofenac and tolperisone in patients with acute ankle ligament injuries resulted in more clinically significant pain reduction and improvement in functional indicators than aceclofenac monotherapy. In the combination therapy group, after completion of treatment on day 15, the severity of pain decreased by 94.8%, the increase in the score on the ADL scale was 62.9 % and on the Sports scale – 70.4 %. In the monotherapy group, pain intensity decreased by 85.1 %, the increase in the score on the ADL scale reached 40.7% and onthe Sports scale – 43.4 %. Throughout the study period, the medications were well tolerated, and no AEs were recorded. Conclusion. The combined use of aceclofenac and tolperisone in patients with acute ankle ligament damage leads to a reduction in pain intensity in a short time, significantly improves indicators of functional activity, promotes a faster return to sports activities, and at the same time has a favourable safety profile.
{"title":"Evaluation of efficacy and safety of combined use of nonsteroidal anti-inflammatory drugs and extended release tolperisone in patients with ankle injuries","authors":"R. I. Sadykov, I. F. Akhtyamov, K. T. Shoshorina, S. A. Lapshina","doi":"10.14412/1996-7012-2023-5-92-96","DOIUrl":"https://doi.org/10.14412/1996-7012-2023-5-92-96","url":null,"abstract":"Ankle capsular ligamentous apparatus damage is one of the most common problems. Ankle injuries account for one-fifth of all lower extremity sports injuries. More than 81 % of acute ankle injuries are treated conservatively, with the rate of unsatisfactory results after this treatment ranging from 2 to 36.9 %. Objective: to evaluate the efficacy and safety of the combined use of aceclofenac (Airtal) and tolperisone (Mydocalm Long) in patients with acute ankle ligament injuries. Material and methods. Sixty patients aged 18 to 65 years with acute ankle ligament injury of grade II according to Kannus and Renstrom, with pain intensity in the joint on a visual analogue scale (VAS) ≥ 50 mm, who had no contraindications for the use of these drugs, participated in the study. Patients in the main group (n = 30) received aceclofenac 100 mg in powder form 2 times daily and tolperisone 450 mg in tablets once daily for 14 days. Patients in the comparison group (n = 30) received only aceclofenac 100 mg in powder form 2 times daily for 14 days. The efficacy of therapy was assessed by pain dynamics according to VAS and functional abilities according to the Foot and Ankle Ability Measure (FAAM) questionnaire, which included the Activities of Daily Living (ADL) subscale and the Sports subscale. To assess safety, laboratory tests were performed at visits 1 and 4, and adverse events (AEs) were assessed at visits 2, 3, and 4. Results and discussion. Combined use of aceclofenac and tolperisone in patients with acute ankle ligament injuries resulted in more clinically significant pain reduction and improvement in functional indicators than aceclofenac monotherapy. In the combination therapy group, after completion of treatment on day 15, the severity of pain decreased by 94.8%, the increase in the score on the ADL scale was 62.9 % and on the Sports scale – 70.4 %. In the monotherapy group, pain intensity decreased by 85.1 %, the increase in the score on the ADL scale reached 40.7% and onthe Sports scale – 43.4 %. Throughout the study period, the medications were well tolerated, and no AEs were recorded. Conclusion. The combined use of aceclofenac and tolperisone in patients with acute ankle ligament damage leads to a reduction in pain intensity in a short time, significantly improves indicators of functional activity, promotes a faster return to sports activities, and at the same time has a favourable safety profile.","PeriodicalId":270571,"journal":{"name":"Sovremennaâ Revmatologiâ","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038528","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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