Sovremennaya Revmatologiya最新文献

{"title":"Влияние тофацитиниба на показатели функции и качества жизни у больных ревматоидным артритом, резистентных к синтетическим и биологическим базисным противовоспалительным препаратам, в реальной клинической практике (результаты многоцентрового наблюдательного исследования)","authors":"Дмитрий Евгеньевич Каратеев, Диана Ильдаровна Абдулганиева, А. Р. Бабаева, Александр Александрович Баранов, Людмила Петровна Евстигнеева, Ольга Николаевна Иванова, Галина Викторовна Лукина, Елена Львовна Лучихина, В. И. Мазуров, А. С. Мисиюк, О. В. Семагина, А. Э. Сизиков, В. Н. Сороцкая","doi":"10.14412/1996-7012-2017-1-12-18","DOIUrl":"https://doi.org/10.14412/1996-7012-2017-1-12-18","url":null,"abstract":"Tofacitinib (TOFA), a representative of a new class of targeted synthetic disease-modifying antirheumatic drugs (s-DMARD), is a promising drug for treating rheumatoid arthritis (RA) and other immune inflammatory diseases. Objective: to evaluate the efficiency and safety of therapy with TOFA in combination with methotrexate (MTX) and other s-DMARDs in real clinical practice in patients with active RA and previous ineffective therapy. Patients and methods. A 6-month Russian multicenter study of function and quality of life enrolled 101 patients with resistant RA: 18 men and 83 women; mean age, 51.03±11.28 years; mean disease duration, 105.4±81.43 months; rheumatoid factor-positive individuals (89.1%); and anticyclic citrullinated peptide antibody-positive ones (74.7%). 93 (92,1%) of these patients completed a 24-week study. TOFA was used as both second-line drug (after failure of therapy with s-DMARD) (n=74) and as a third-line drug (after failure of therapy with s-DMARDs and biological agents (BAs) (n=74). The tools RAPID3, HAQ, and EQ-5D were used to determine disease outcomes from a patient's assessment. Results. All the three tools demonstrated significant positive changes at 3–6 months following therapy initiation. RAPID3 scores for the status of a patient achieving a low disease activity or remission coincided with the mean DAS28-ESR and SDAI scores in 60% and 68% of cases, respectively. The achievement rates of the minimally clinically significant improvement (ΔHAQ≥0.22) and functional remission (HAQ≤0.5) at 6 months of TOFA therapy were 79.6 and 30.1%, respectively. The mean change value in EQ-5D scores over 6 months was -0.162±0.21. There were no significant between the groups of patients who used TOFA as a second- or third-line agent in the majority of indicators, except EQ-5D scores at 6 months. Conclusions. The results of our multicenter study using considerable Russian material confirmed the pronounced positive effect of TOFA used as a second-line agent (after s-DMARD failure) and a third-line agent (after s-DMARD and BA failure) on patients' assessment of disease activity, functional ability in daily life, and quality of life.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"29 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2017-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66948260","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":"Остеоартрит и возраст. Роль старения в этиологии и патогенезе заболевания","authors":"Л. В. Лучихина, О. И. Мендель, В. Мендель, Г. Н. Голухов","doi":"10.14412/1996-7012-2017-1-4-11","DOIUrl":"https://doi.org/10.14412/1996-7012-2017-1-4-11","url":null,"abstract":"The paper considers current views on the mechanisms for the development and progression of osteoarthritis (OA) and gives the definition of the disease. It describes the processes underlying aging and OA at the molecular and cellular level, with emphasis on the role of chronic nonspecific inflammation. The possible mechanisms of chronic age-related inflammation (inflammaging), the mainstay of which is systemic aging of the immune system, are characterized. On the basis of the data available in the literature, it is concluded that aging and OA have common intracellular transcription cascades and pathophysiological mechanisms: chronic nonspecific inflammation and metabolic disorders are substantially implicated in the pathogenesis of these conditions. Metabolic and structural changes occurring in the cartilage and other tissues of the locomotor apparatus with aging are noted to serve as a favorable platform for the further development and progression of OA.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"11 1","pages":"4-11"},"PeriodicalIF":0.0,"publicationDate":"2017-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66948294","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":"Роль витаминов-антиоксидантов в этиологии ревматоидного артрита","authors":"Ж. В. Максимова, Д. М. Максимов","doi":"10.14412/1996-7012-2017-1-56-61","DOIUrl":"https://doi.org/10.14412/1996-7012-2017-1-56-61","url":null,"abstract":"There is evidence that insufficient intake of antioxidants may increase the risk of autoimmune inflammatory diseases, including rheumatoid arthritis (RA). Also, lower plasma concentrations of antioxidant vitamins can be a sign of their heavy expenditure to suppress inflammatory processes in the preclinical stage of RA. This article provides an overview of modern studies that have assessed a relationship between the incidence of RA and serum levels or dietary intake of vitamins A, E, C and beta-carotene. Case-control studies have revealed that α-tocopherol and β-cryptoxanthin have a protective effect and their high plasma levels are associated with the decreased incidence of RA. An inverse relationship has been also found between the dietary intake of carotenoids and vitamin C and the risk of RA. At the same time, larger prospective cohort studies have failed to confirm the relationship between the levels of consumption of the major antioxidant vitamins and the risk of RA. The currently available data on the role of antioxidant vitamins in the development of RA remains controversial. Conceivably, sufficient intake of the vitamins has no self-protective activity against RA, but serves as a marker for a healthier lifestyle that lowers the risk of many diseases, including autoimmune disorders.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"11 1","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2017-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48530641","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":"Применение тофацитиниба для лечения больных ревматоидным артритом, резистентных к синтетическим и биологическим базисным противовоспалительным препаратам, в реальной клинической практике ( результаты многоцентрового наблюдательного исследования)","authors":"Дмитрий Евгеньевич Каратеев, Диана Ильдаровна Абдулганиева, А. Р. Бабаева, Александр Александрович Баранов, Людмила Петровна Евстигнеева, Ольга Николаевна Иванова, Галина Викторовна Лукина, Елена Львовна Лучихина, В. И. Мазуров, А. С. Мисиюк, О. В. Семагина, А. Э. Сизиков, В. Н. Сороцкая","doi":"10.14412/1996-7012-2016-3-52-61","DOIUrl":"https://doi.org/10.14412/1996-7012-2016-3-52-61","url":null,"abstract":"Tofacitinib (TOFA), a member of a new class of targeted synthetic disease-modifying antirheumatic drugs (DMARDs), is a promising medication for the treatment of rheumatoid arthritis (RA) and other immunoinflammatory diseases. The paper describes the Russian experi-ence with TOFA used to treat severe RA. Patients and methods. 101 RA patients (18 men and 83 women; mean age, 51.03±11.28 years; mean disease duration, 105.4±81.43 months) who were positive for rheumatoid factor (89.1%) and anti-cyclic citrullinated peptide antibodies (74.7%) and resistant to therapy with synthetic DMARDs (sDMARDs) (80.2%) and biological agents (19.8%) were given TOFA at a dose of 5 mg twice daily, which could be doubled if necessary. TOFA was used alone (n=9) or in combination with methotrexate (MT) (n=75) or other sDMARDs (n=17). The achievement of low disease activity (LDA) and clinical remission at 3 and 6 months of treatment by DAS28-ESR SDAI, and CDAI scores, and the indices of safety and tolerability were assessed. Results. A total of 93 (92.1%) of the 101 patients completed a 24-week period of the investigation. 8 (7.9%) patients prematurely discontinued TOFA after an average of 2.75±0.71 months. At the end of the study, the patients achieved the primary endpoint (LDA including remission) in terms of DAS28-ESR ≤3.2 (34.7%), SDAI ≤11 (47.5%), and CDAI ≤10 (48.5%) and the secondary endpoints (clinical remission) in terms of DAS28-ESR ≤2.6 (17.8%), SDAI ≤3.3 (8.9%), and CDAI ≤2.8 (6.9%). When TOFA was combined with MT, the discontinuation rate for the former was significantly lower (2.7%) than when TOFA was used in combination with other sDMARDs (29.4%) or alone (11.1%; p<0.01). At 3 and 6 months of follow-up, LDA was achieved more frequently when TOFA was combined with MT than when other treatment regimens were used. Fatal outcomes and serious adverse events (AEs), as AEs previously undescribed in the literature, were not seen during a follow-up within the framework of the clinical trial. Only 2 patients discontinued TOFA because of AEs. Conclusion. The use of TOFA in RA is effective in achieving LDA in patients unresponsive to sDMARDs and biological DMARDs. The prescription of the drug makes it possible to monitor the activity of the inflammatory process and, with its sufficient safety and good tolerability, to achieve LDA in half of the patients, including those with multidrug resistance.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"10 1","pages":"52-61"},"PeriodicalIF":0.0,"publicationDate":"2016-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66947803","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":"Экономические аспекты осложненного остеопороза: стоимость лечения в течение первого года после перелома","authors":"О. В. Добровольская, Наталья Владимировна Торопцова, Ольга Михайловна Лесняк","doi":"10.14412/1996-7012-2016-3-29-34","DOIUrl":"https://doi.org/10.14412/1996-7012-2016-3-29-34","url":null,"abstract":"Objective: to estimate the cost of treatment in patients with complicated osteoporosis (OP) in the first year after fracture under the conditions of the Moscow municipal healthcare system. Patients and methods. The investigation enrolled 196 women (mean age, 65.8±9.1 years) who had sustained fractures at five major osteoporotic sites (proximal hip (PH), distal forearm (DF), surgical humeral neck, vertebral column, and medial and/or lateral ankle). A unified questionnaire that included data on inpatient and outpatient treatment, patients' personal costs, and social benefits, as well as tariffs on services of the Moscow City Fund of Obligatory Health Insurance was used to estimate the cost of treatment for complicated OP during one year after fracture. Results . The direct cost of treatment for PH fracture amounted to 101,243 rubles and was significantly higher (p < 0.01) than that for fractures at other sites: DF (22,080 rubles); humeral neck (39,855 rubles), vertebral column (51,167 rubles), and ankle (43,345 rubles). The average cost of treatment in terms of indirect costs of treatment for complicated OP during a year was as high as 61,151 rubles. In the overall cost structure for the disease, hospital costs accounted for 44%; social benefits were 12% and the cost of antiosteoporotic drugs was only 7%, which was associated with the fact that the latter were rarely prescribed by primary healthcare physicians. Conclusion. Costs of treatment in patients with complicated OP in Moscow were estimated in relation to the site of low-energy fracture. The disease was shown to cause considerable economic losses regardless of the site of osteoporotic fracture; however, the cost of antiosteoporotic drugs has an insignificant share in the overall cost structure for treatment. At the same time, secondary prevention of OP requires that combination antiosteoporotic therapy should be performed in all patients who have sustained low-energy fracture.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"10 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2016-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66948164","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":"Patient-level costs of major cardiovascular conditions: a review of the international literature.","authors":"Gina Nicholson, Shravanthi R Gandra, Ronald J Halbert, Akshara Richhariya, Robert J Nordyke","doi":"10.2147/CEOR.S89331","DOIUrl":"10.2147/CEOR.S89331","url":null,"abstract":"<p><strong>Objective: </strong>Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events.</p><p><strong>Methods: </strong>MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values.</p><p><strong>Results: </strong>Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union.</p><p><strong>Conclusion: </strong>This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.</p>","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"2 1","pages":"495-506"},"PeriodicalIF":2.1,"publicationDate":"2016-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89060659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Артериальная гипертензия у больных подагрой: основы патогенеза, клиническое значение, диагностика","authors":"E. I. Markelova, M. S. Eliseyev, V. G. Barskova","doi":"10.14412/1996-7012-2012-759","DOIUrl":"https://doi.org/10.14412/1996-7012-2012-759","url":null,"abstract":"Cardiovascular diseases (CVD) caused by vascular atherosclerotic lesion are the leading cause of death in gout patients. Analysis of the data available in the literature has indicated that monitoring blood pressure and target organ damage thoroughly serves as the basis for the prevention of CVD and cardiovascular catastrophes in patients with gout.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"6 1","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2012-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66948074","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":"Комментарии к рекомендациям EULAR по лечению системной склеродермии","authors":"Андрей Владимирович Волков","doi":"10.14412/1996-7012-2009-549","DOIUrl":"https://doi.org/10.14412/1996-7012-2009-549","url":null,"abstract":"","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"3 1","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2009-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66947938","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":"Ревматические проявления при вирусных гепатитах","authors":"L. P. Anan'eva, L. P. Ananyeva","doi":"10.14412/1996-7012-2008-499","DOIUrl":"https://doi.org/10.14412/1996-7012-2008-499","url":null,"abstract":"Autoimmune reactions are of primary importance in the development of extrahepatic manifestations of viral hepatitis, among which there are rheumatic symptoms and syndromes. The incidence of clinically significant extrahepatic manifestations is shown to be relatively low, but they may be in the foreground in the clinical picture of the disease and are noted for severity. It is concluded that due to the high prevalence of hepatitis and the systemic pattern of their chronic forms, patients with extrahepatic manifestations of viral hepatitis may be encountered in the practice of a therapist and a rheumatologist. The onset of the infection caused by hepatitis viruses may be accompanied by articular lesion therefore the rheumatologist may be the first physician such a patient may resort to.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"2 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2008-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66947298","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":"Диагностика легочной гипертензии при системной склеродермии","authors":"Андрей Владимирович Волков","doi":"10.14412/1996-7012-2008-502","DOIUrl":"https://doi.org/10.14412/1996-7012-2008-502","url":null,"abstract":"Pulmonary hypertension (PH) associated with scleroderma systematica (SDS) is a menacing manifestation of this systemic disease of connective tissue, in which a rapid progression results in very poor outcomes. In SDS, PH is more frequently observed with the prolonged disease, circumscribed skin lesion, develops after a long benign course, and is one of the common causes of death. The early stage of PH can be identified by instrumental and not always accessible studies. The stage of clinical manifestations, which is frequently manifested only by dyspnea, requires a differential diagnosis from a wide range of conditions both caused by and concurrent with SDS. The need for differential diagnosis stems from the varying course and prognosis of the disease, as well as treatment policy.","PeriodicalId":36215,"journal":{"name":"Sovremennaya Revmatologiya","volume":"2 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2008-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66947787","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}