Kardiorespirator tadqiqotlar jurnali. Maxsus son. 2022
Maqola mavzusi
RENEWED APPROACH TO MANAGMENT OF RHEUMATOID ARTHRITIS IN EARLY STAGES (455-460)
Mualliflar
Nabieva D.A.,, Tashpulatova M.M.
Muassasa
Tashkent Medical Academy
Annotatsiya
Objective: To optimize the methods of the basic treatment of early rheumatoid arthritis (RA).years. By random assignment, patients were randomized into three groups: 1st group monotherapy with methotrexate (MTX) 10-20 mg / week (MTX; n = 40); 2nd group – MTX combined with small doses of glucocorticosteroids (GC) prednisolone in a dose of 10 mg per day orally (MTX + GC; n = 30); 3rd group - monotherapy with leflunomide (LF) 20 mg / day (LF; n = 20). Patients were allowed to continue taking nonsteroidal anti-inflammatory drugs (NSAIDs) in the previous doses, as well as external using of antiinflammatory drugs, exercise therapy, physiotherapy and occupational therapy if demanded,. If necessary, conducted intra-articular GC, but no more than 1 per in 1 month using 1 ml diprospan per administration. All patients before treatment and during follow-held standart clinical, laboratory and instrumental examination. Total activity of disease assessed by DAS28 index which recommended by the EULAR with the release of the 4 major powers. Results: The positive dynamics of the basic clinical and laboratory manifestations of early RA under the influence of all analyzed therapeutic options was evident. Thus a significant reduction of disease activity as compared to baseline was maintained at 3, 6 and 12 months of treatment. This represents a significant and long-term therapeutic effect as monotherapy LF and MTX as well as combination MTX with GC. Conclusion: All the studied variants of therapy in patients with early RA have demonstrated a significant efficacy and a very reasonable safety. Therefore, each of the schemes can be used to treat these patients with a high probability of achieving a significant improvement. Keywords: early rheumatoid arthritis, combination therapy, the basic anti-inflammatory drugs
Kalit so'zlar
early rheumatoid arthritis, combination therapy, the basic anti-inflammatory drugs
Adabiyotlar
1. D.E. Karateev // Main trends and variability in the evolution of rheumatoid arthritis: results of longterm observation. Scientific and practical rheumatology. 2004. No. 1 P. 8-14 2. D. E. Karateev, V. A. Nosnova, S. A. Radenska-Lopovok, M. M. Ivanova // Synovial membrane at the early stage of rheumatoid arthritis: clinical and morphological comparisons. Ter. Archive. 2002 No. 5 P. 13-20. 3. A.M. Van Gestel, J.J. Anderson // ACR and EULAR improvement criteria have comparable validity in rheumatoid arthritis trials. J. Rheumatol. 1999 (26) P.11. 4. B. M. Van den, L. L. Driven, N. L. Klarcnbcck // Clinical and radiological outcomes of four disease activity driven treatment strategics: 8-year results of the BEST study. Ann Rheum Dis. 2012 (3). P. 71. 5. E.V. Fedorenko, G.V. Lukina, Ya.A. Sigidin, E.L. Luchikhina, D.Ye. Karateev // Comparative efficacy and tolerability of modern methods of therapy for early rheumatoid arthritis. Scientific and practical rheumatology. 2015 (2). P. 162-168. 6. J.W.Bijlsma, M.E. Wcinblatt // Optimal use of the methotrexate: the advantages of tight control. Ann Reum Dis. 2007. P.11. 7. J.R. Kalden, M.S. Shattenkirchner // The effi¬cacy and safety of leflunomide in patients with active rheumatoid arthritis: a five-year follow up study. Arthr.Rheum. 2003. R.1513-1520. 8. P.M. Balabanova, D.E. Karateev, R. Yu. Kashevarov, E.L. Luchikhina // Scientific and practical rheumatology. 2005 No. 5. P.31. 9. J.A. Stanich, J.D. Carter // Rheumatoid arthritis: disease or syndrome? Open Access Rheumatology Research and Reviews. 2009 No. 1 (179). R. 92. 10. L.G. Schipper, M.M. Vermeer, H.H. Kuper // A tight control treat¬ment strategy aiming for remission in early rheumatoid arthritis is more effective than usual treatment in daily clinical practice: a study of two cohorts in the Dutch Rheumatoid Arthritis Monitoring registry. Ann Rheum Dis. 2012 No. 7l (6) P.50. 11. N.A. Vinogradova // The effect of combined therapy with glucocorticoids and methotrexate on articular destruction in rheumatoid arthritis. Diss. Cand. medical sciences. Moscow. 2004.S. 134.