ObjectivesTo compare the efficacy and safety of innovator infliximab (INX) and CT-P13, an INX biosimilar, in active rheumatoid arthritis patients with inadequate response to methotrexate (MTX) treatment.MethodsPhase III randomised, double-blind, multicentre, multinational, parallel-group study. Patients with active disease despite MTX (12.5–25 mg/week) were randomised to receive 3 mg/kg of CT-P13 (n=302) or INX (n=304) with MTX and folic acid. The primary endpoint was the American College of Rheumatology 20% (ACR20) response at week 30. Therapeutic equivalence of clinical response according to ACR20 criteria was concluded if the 95% CI for the treatment difference was within ±15%. Secondary endpoints included ACR response criteria, European League Against Rheumatism (EULAR) response criteria, change in Disease Activity Score 28 (DAS28), Medical Outcomes Study Short-Form Health Survey (SF-36), Simplified Disease Activity Index, Clinical Disease Activity Index, as well as pharmacokinetic (PK) and pharmacodynamic (PD) parameters, safety and immunogenicity.ResultsAt week 30, ACR20 responses were 60.9% for CT-P13 and 58.6% for INX (95% CI −6% to 10%) in the intention-to-treat population. The proportions in CT-P13 and INX groups achieving good or moderate EULAR responses (C reactive protein (CRP)) at week 30 were 85.8% and 87.1%, respectively. Low disease activity or remission according to DAS28–CRP, ACR–EULAR remission rates, ACR50/ACR70 responses and all other PK and PD endpoints were highly similar at week 30. Incidence of drug-related adverse events (35.2% vs 35.9%) and detection of antidrug antibodies (48.4% vs 48.2%) were highly similar for CT-P13 and INX, respectively.ConclusionsCT-P13 demonstrated equivalent efficacy to INX at week 30, with a comparable PK profile and immunogenicity. CT-P13 was well tolerated, with a safety profile comparable with that of INX.ClinicalTrials.gov IdentifierNCT01217086

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We assessed the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in 2010 in adults from four cities in Russia, Kazakhstan and Ukraine. Individuals with SLE were identified retrospectively from the medical records of specialized centers. Prevalent SLE patients were nondeceased city residents, diagnosed prior to December 31, 2010; incident patients were residents newly diagnosed between January 1 and December 31, 2010. Population size was obtained from official census data. The observed prevalence rates (per 100,000, 95% CI) were 9.0 (7.1-11.2) in Kursk and Yaroslavl, Russian Federation; Kazakhstan; in Vinnitsa, Ukraine. The cumulative incidence rates (per 100,000, 95% CI) were 1.4 (0.7-2.4); 1.6 (0.4-4.1) and 0.3 (0.0-1.8), correspondingly. All rates were higher among females compared to males, and incidence peaked in the population aged 25-44. These rates appear slightly lower than those reported from Western Europe and the USA. This could be because of study design (case-ascertainment), local health care practices or true differences in disease risk. Case age and sex distribution was similar to the known epidemiology of SLE. The rates were highest in Kazakhstan, likely because of a predominantly ethnic Asian population. Lupus (2014) 23, 213-219.

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The synthesis and X-ray structure of a C 2 symmetric secochlorin 2, obtained by a photosensitized oxidative ring opening of a 2,3-dimethoxy porphyrin, is described. † Electronic supplementary information (ESI) available: experimental details. See http://www.rsc.org/suppdata/cc/b1/b102139g/ Scheme 1 Fig. 1 Absorption spectra of porphyrin 4 and secochlorin 2. CH 2 Cl 2 solutions, room temperature.

Nowadays low paraoxonase activity is generally recognized as an independent risk factor of cardiovascular diseases involved in pathologic remodeling of the heart and vessels as well as thrombosis in the general population. But the role of paraoxonase activity in RA patients is unknown. Based on the above, the aim of the work was to study serum paraoxonase activity in patients with rheumatoid arthritis, to evaluate its association with clinical course and structural and functional status of the cardiovascular system. 67 patients with RA, 18 males and 49 females were studied. The control group consisted of 25 apparently healthy individuals. Rheumatoid arthritis was diagnosed according to international classification criteria ACR 2012. The indices of total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and triglycerides (TG) in blood serum were determined by standard conventional methods. Low density lipoprotein cholesterol (LDLC) values were calculated by Friedwald formula. Serum paraoxonase activity was measured by spectrophotometric method. High resolution ultrasound and Doppler ultrasonography of the brachial artery were performed to study endothelium function. Sonographic B-mode scanning and pulsed Doppler ultrasound of heart and blood flow spectra were done on ultrasound scanner. Serum paraoxonase activity was found to be about 18.8% lower in the patients with RA than in the control group. Serum paraoxonase activity was shown to decrease proportionally to the increase of the age in RA patients. In the group of patients over 45, the level of the enzyme was 13.0% lower than in the patients over 30. The study established that the increase of systolic and diastolic arterial pressure is associated with decrease of serum paraoxonase activity in RA patients. The patients with RA combined with arterial hypertension had significantly (by 10.9%) lower activity of the studied enzyme than those with no arterial hypertension. However, no significant relationship between paraoxonase activity and duration of the disease, obesity and smoking was revealed. Paraoxonase activity in RA patients was demonstrated to be dependent on lipid levels. The lowest paraoxonase activity was recorded in individuals with the highest levels of TC, LDLC and the lowest HDLC indices. Paraoxonase activity in RA patients is associated not only with atherosclerotic vascular damage (IMT, decreased FMDBA) but also with structural and functional heart status (systolic and diastolic functions, left ventricular myocardial hypertrophy). Decreased serum paraoxonase level is suggested to be the predictor of early development of cardiovascular complications in RA patients.

Specialist visits are the most frequently consumed SLE-related healthcare recourse in the Commonwealth of Independent States (CIS) countries. A relapsing-remitting SLE profile and the occurrence of flares significantly raise healthcare resource consumption.

Media. -A new terpyrrolic analogue (I) of dipyrrolylquinoxaline is presented as an improved colorimetric and fluorescent sensor of halide and dihydrogen phosphate anions in organic media. -(SHEVCHUK, S. V.; LYNCH, V. M.; SESSLER*, J. L.; Tetrahedron 60 (2004) 49, 11283-11291; Dep. Chem. Biochem., Univ. Tex., Austin, TX 78712, USA; Eng.) -Mischke 10-115