Effective Pharmacotherapy最新文献

{"title":"Interleukin 6 Receptor Inhibitor Levilimab in the Treatment of Rheumatoid Arthritis","authors":"D. Karateev, E. Luchikhina","doi":"10.33978/2307-3586-2022-18-18-6-10","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-18-6-10","url":null,"abstract":"The inhibitors of the biological effects of interleukin 6 (IL-6) are the most actively developing group of biologics for the treatment of rheumatoid arthritis (RA) due to pleiotropic effects of this most important pro-inflammatory cytokine, which stimulates a number of processes that play an important role in the pathogenesis of RA. IL-6 receptor (IL-6R) is of great importance in the implementation of these biological effects. Activation of IL-6R occurs with the participation of the glycoprotein gp130 in three variants: classical, and in trans-signaling and trans-presentation modes. The most recent representative of this group is levilimab, an IgG1 monoclonal antibody to IL-6R that binds both soluble and membrane forms of the receptor. The efficacy and safety of levilimab has been demonstrated in the Phase II AURORA and Phase III SOLAR trials. The paper presents the main statements of the resolution of the regional expert council of rheumatologists of Moscow and the Moscow Region on the topic: ‘The place of a new IL-6R inhibitor levilimab in the treatment of patients with rheumatoid arthritis’, which took place on December 18, 2021 in Moscow. The panel of experts confirmed that levilimab is recommended for widespread use in patients with active RA who fail or are intolerant to traditional synthetic DMARDs.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77740021","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}

{"title":"Practical Guidelines for Radiological Investigation Methods in Rheumatoid Arthritis and Ankylosing Spondylitis","authors":"D. Karateev, E. Stepanova, E. Luchikhina","doi":"10.33978/2307-3586-2022-18-18-12-25","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-18-12-25","url":null,"abstract":"Radiological examination remains the \"gold standard\" for instrumental diagnosis of the most common immunoinflammatory rheumatic diseases – rheumatoid arthritis (RA) and ankylosing spondylitis (AS). This publication discusses the indications and methodological aspects of performing standard radiography of the musculoskeletal system in RA and AS. It also describes the main radiological symptoms, methods for assessing the staging of the disease (according to O. Steinbrocker and J. Kellgren), methods for assessing radiological progression: in RA – according to J.T. Sharp/D.M. van der Heijde and A. Larsen, in AS – mSASSS, RASSS, BASRI.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82496354","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}

{"title":"Modern Approaches to the Diagnosis and Therapy of Reactive Arthritis","authors":"B. Belov, N. V. Muravyova, S. Erdes","doi":"10.33978/2307-3586-2022-18-18-26-33","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-18-26-33","url":null,"abstract":"Currently, the problem of reactive arthritis (ReA) remains important. This is due to the sufficiently high prevalence of the disease. The analysis of epidemiological data allows us to put forward a number of possible reasons explaining the different frequency of ReA in certain regions of the Russian Federation and in other countries. The article details the clinical picture of the disease, analyzes the significance of various laboratory techniques aimed at identifying the causative agent of ReA. The main approaches to the therapy of ReA, including the use of antimicrobial drugs, are described.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77625329","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}

{"title":"Spa Treatment of Children with Congenital Epidermolysis Bullosa","authors":"I.L. Zakhartsova, V. D. Ostapishin","doi":"10.33978/2307-3586-2022-18-16-20-23","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-16-20-23","url":null,"abstract":"Epidermolysis bullosa (EB) belongs to the group of genetically and clinically heterogeneous diseases characterized by the formation of blisters and erosions on the skin and mucous membranes, vulnerability and sensitivity of the skin to minor mechanical injury (mechanobullous disease). According to unconfirmed reports, there are 2-2.5 thousand children with congenital epidermolysis in Russia. There are no radical methods of treatment for any form of EB. All therapeutic measures are palliative, aimed primarily at preventing injuries and blisters arising on their background with the help of optimal skin care and affected areas. Since 2018, in the ‘Avangard’ Sanatorium of the Branch of ‘Children's Medical Center’ the Federal State Budgetary Institution of the Administration of the President of RF in Sochi, within the framework of cooperation with the ‘Butterfly Children’ Charity Foundation, children with congenital epidermolysis receive rehabilitation and spa treatment. Individual treatment programs and psychological assistance specially developed for children are aimed at preventing the occurrence of new rashes, regression of vesicular and erosive-ulcerative rashes, improving the quality of life of patients. During our work with such children, we have managed to achieve certain results in treatment and rehabilitation. Spa treatment of children with congenital BE is an integral part of comprehensive treatment.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"217 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89360855","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}

{"title":"Ebstein's Anomaly","authors":"V. Delyagin, N. Doctorova, I.Ye. Belokrinitskaya","doi":"10.33978/2307-3586-2022-18-16-14-19","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-16-14-19","url":null,"abstract":"Ebstein’s anomaly is a rare congenital malformation characterized by apical displacement of the right atrioventricular ring with an anomaly of the development of the tricuspid valve and the frequent presence of other heart defects. According to our data, this defect was diagnosed in 2 cases in more than 6 000 sectional studies: in an adult and a child. According to the echocardiography rooms of non-specialized multidisciplinary children's hospitals and children's polyclinics, the defect is detected with a frequency of 1:24.000–1:32.000 studies. Genetic and environmental factors (viral infections, benzodiazepines, lithium) are indicated as probable causes. Clinical signs are cyanosis, shortness of breath, heart failure, cardiac arrhythmias. Morphologically there are abnormalities of the tricuspid valve, papillary muscles and chordal apparatus, right ventricular myocardial hypertrophy, thinning of the walls of the right atrium and atrialized part of the right ventricle. Decisive for the diagnosis is ultrasound. Displacement of the right atrioventricular ring is revealed. The degree of bias determines the severity of the defect. The amplitude of the tricuspid valve movement is increased. Its valve closure occurs later than the mitral. A 40 ms difference between the tricuspid and mitral valve closure points is a diagnostically important sign of Ebstein’s anomaly. The tactics of a doctor are determined by the clinical picture","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80206461","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}

{"title":"Resort Pediatrics","authors":"V. D. Ostapishin","doi":"10.33978/2307-3586-2022-18-16-24-26","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-16-24-26","url":null,"abstract":"The group of frequently ill children includes children who respiratory disease more 6 times per year or more frequently than once per month during the period of maximum incidence from October to March. In Russia the share of frequently ill children in the general population ranges from 15 to 75%, of whom two-thirds are children aged 3 to 6 years. In this regard, schemes of innovative restorative treatment are becoming particularly relevant, allowing to increase the effectiveness of rehabilitation of children and strengthen the adaptive capabilities of the body.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73016929","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}

{"title":"Features of the Immune Response and the Possibility of Correcting the Maladaptation of the Immune Response in Patients with Acute Respiratory Viral Infections from Organized Groups","authors":"V. Akimkin, Z. Ponezheva, L. O. Ponezheva, T. S. Guseva, O. Parshina, A. N. Turapova","doi":"10.33978/2307-3586-2022-18-16-8-13","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-16-8-13","url":null,"abstract":"The purpose of the study was to determine the severity of maladaptation disorders of the immune response and the possibility of their correction in patients with acute respiratory viral infections from organized groups. Material and methods. 90 patients with uncomplicated forms of ARVI and a group of conditionally healthy (n = 30) from organized groups were examined. In addition to symptomatic therapy, patients received a combination of rectal and intranasal forms of recombinant IFN-α-2b. Identification of the ARVI pathogen was determined by PCR. ELISA was used to determine serum concentrations of IFN-α and IFN-γ and the ability of blood cells to produce these cytokines ex vivo spontaneously and when stimulated by Newcastle disease virus or phytohemagglutinin. Flow cytometry was used to analysis the subpopulation composition of peripheral blood lymphocytes. The study of the levels of secretory IL-8, IgA, serum IL-8 was carried out by enzyme immunoassay. Results. The etiology of ARVI was deciphered in 62.1% of patients, the main share in the morbidity structure was due to influenza (39.3%) and adenoviruses (35.6%). In the first 3 months of the formation of organized teams in apparently healthy people, a decrease in the level of T-helpers, natural killers and inhibition of the interferon system was revealed, which indicates a violation of adaptive mechanisms and contributes to a decrease in body resistance. An analysis of the cytokine system showed an increase in the concentration of secretory and serum IL-8 in patients with acute respiratory viral infections compared with a group of practically healthy people. In the immune status 1 month after ARVI, there was a significant increase in the number of T-lymphocytes, T-helpers with a tendency to normalize T-lymphocytes carrying IFN-α and -γ receptors, while maintaining a significantly reduced number of B-lymphocytes. The immunomodulatory efficacy of combination therapy with recombinant IFN-α-2b is characterized by an increase in the amount of induced IFN-α during its initial depression and a decrease in initial hyperproduction. Also, at the initial level of induced IFN-α less than 200 pg/ml, there was an increase in the concentration of secretory IL-8 and IgA. Conclusion. In conditionally healthy individuals, in the first 3 months of the formation of organized groups, maladjustment disorders in the immune response were detected in 34% of cases. The interferon-modulating effect of combination therapy with recombinant IFN-α-2b was shown.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80193881","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}

{"title":"Structure and Ways of Strengthening Human Psychological Resources in Stress Situation","authors":"L. D. Firsova","doi":"10.33978/2307-3586-2022-18-14-48-52","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-14-48-52","url":null,"abstract":"The negative impact of chronic stress on the development, treatment and prognosis of gastroenterological diseases is beyond doubt. In recent years, much attention has been paid to the mental state of the doctors themselves, as a result, such a category as professional burnout syndrome is generally recognized. One of the best ways out of stressful situations is to activate the psychological resource of a person. The lecture gives a definition of a psychological resource with a detailed description of its components, special attention is paid to the issues of its strengthening in a situation of chronic stress. The issues discussed are significant for gastroenterologists both in terms of communication with patients and in terms of regulating their own mental state.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75248291","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}

{"title":"Dumping Syndrome: a Modern View of Pathogenesis, Diagnosis and Treatment","authors":"O.Yu. Gasieva, Y. Embutnieks, O. Berezina, D. Bordin","doi":"10.33978/2307-3586-2022-18-14-42-47","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-14-42-47","url":null,"abstract":"The literature review summarizes modern ideas about the pathogenesis of dumping syndrome, a pathological condition that occurs after gastric resection. Presented the principles of detecting and correcting of the manifestations of dumping syndrome, which allow improving postoperative rehabilitation and ensuring the acceptable quality of life for patients.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73518369","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}

{"title":"Viral Hepatitis Is a Possible Trigger for Autoimmune Liver Diseases","authors":"E. Sbikina, S. Batskikh, A. Dorofeev, E. Vinnitskaya, J.B. Borunova, K. Saliev, Y. Sandler, T. Khaimenova, D. Bordin","doi":"10.33978/2307-3586-2022-18-14-28-34","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-14-28-34","url":null,"abstract":"In recent years, there has been an increase in the incidence of autoimmune liver diseases (AILD) among women and men in all age groups, their etiology remains unknown. The purpose of the study. To confirm the possible role of hepatitis viruses in the development of AILD. Material and methods. During the period 2019–2021, 141 patients with AILD were examined in the department of chronic liver Diseases of Moscow Clinical Scientific and Practical center named after A.S. Loginov of the Moscow Department of Health. The examination included the determination of anti-HAV IgG, anti-HEV IgG, HBsAg, anti-HBcorе IgG, anti-HBs, anti-HCV, DNA HBV, RNA HCV, ANA-НЕр-2, liver fibroelastometry (FE), magnetic resonance cholangiopancreatography (MRCP), liver biopsy (LB). The risk of developing AILD in people who have had hepatitis A, B, and E virus infections was assessed by calculating the odds ratio. Statistical processing was carried out by standard methods. Results. The main group consisted of patients with AILD (n = 139) of them with AIH (n = 46), PBC (n = 74), PSC (n = 19), the control group (KG) (n = 125) – without chronic liver diseases. The high prevalence of IgG class antibodies to hepatitis viruses (HV) A, B, E was reliably demonstrated among patients with AILD (n = 104; 74.8%) compared with KG (n = 68; 54.4%), P < 0.001, and anti-HCV was most often detected (n = 87; 63%), p < 0.002 and anti-HBcore (n = 36;25%), p < 0.031. The highest prevalence of anti-HAV and anti-HBcore was determined – 70% (p < 0.001) and 29% (p < 0.016), respectively, in the PBC group. No significant differences were obtained for PSC and AIH. HBV DNA was detected in the blood of two patients n = 2 (2.5%), that the presence of DNA latent viral hepatitis B. Conclusion. As a result of the study, the epidemiological relationship of transferred viral hepatitis A and B with AILD (in particular, PBС) was revealed. The data obtained confirm the role of hepatitis viruses as possible triggers of AILD and the probable involvement of HBV infection in the pathogenesis of PBC.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90997825","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}