Comorbidity in Patients With Rheumatoid Arthritis

Никитина, Н. М.; Афанасьев, И. А.; Ребров, А. П.

doi:10.14412/1995-4484-2015-149-154

Cited by 12 publications

(9 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…По данным литературы положительное отношение к приёму лекарственных препаратов и значительная осведомленность о медикаментозном лечении были связаны с более высокими показателями приверженности терапии [23,24]. Коморбидная патология широко распространена у пациентов с РА [5]. Сочетание различных заболеваний создает дополнительные трудности терапии и способствует снижению эффективности проводимого лечения [5].…”

Section: материалы и методыunclassified

“…Коморбидная патология широко распространена у пациентов с РА [5]. Сочетание различных заболеваний создает дополнительные трудности терапии и способствует снижению эффективности проводимого лечения [5]. По мнению исследователей, наличие сопутствующих заболеваний (ишемическая болезнь сердца, гипертония, ХОБЛ, хроническая болезнь почек и заболевания печени) могут оказывать как отрицательное [21,22], так и положительное влияние на приверженность лечению [15].…”

Section: материалы и методыunclassified

“…По результатам проведенного ранее в нашей клинике исследования больных РА (n=328) коморбидные состояния выявлялись у 86,6% пациентов. При этом отмечено 163 эпизода отмены синтетических базисных противовоспалительных препаратов (БПВП), что было связано с ухудшением течения коморбидной патологии [5]. Беляловым Ф.И.…”

unclassified

See 2 more Smart Citations

Problems of treatment adherence in patients with rheumatoid arthritis and comorbidity

Никитина

Жданов

Мелехина³

et al. 2020

Arhivʺ vnutrennej mediciny

Self Cite

View full text Add to dashboard Cite

Aim of the study. Evaluation of treatment adherence in patients with rheumatoid arthritis (RA) and comorbidity.Materials and methods. One hundred thirty-two women (mean age: 55.5 ± 10.5 years) with proven RA (mean duration of disease: 10.2 [4; 14] years) were included in this study. Patients with moderate and high disease activity were prevalent (average DAS28: 5.0 [4.3; 5.8]). All patients had comorbidities. All patients underwent clinical examination, laboratory evaluation and imaging. Functional capacity was assessed using the Steinbroker classification (functional class — FC) and Stanford Health Assessment Questionnaire (HAQ). Pain severity was evaluated using visual analog scale (VAS). Patients’ social status was assessed. Baseline adherence to treatment was evaluated using two questionnaires. Morisky-Green questionnaire was used to evaluate general adherence to treatment among 132 (100%) patients. Quantitative evaluation of treatment adherence was performed in 82 (62.1%) patients using N.A. Nikolaev questionnaire.Results. Analysis of adherence to treatment as assessed by Morisky-Green questionnaire has established that 68 (52.3%) of patients are non-adherent to treatment. Low treatment adherence as assessed by Nikolaev questionnaire was found in 33 (40.3%) of patients. Lifestyle modification was characterized by lowest adherence. Young age, lower duration of disease and lower income were predictive of higher adherence to treatment. Non-adherent patients had higher RA activity index and lower functional capacity.Conclusion. Simultaneous use of several methods to assess treatment adherence is a reasonable way to get more information about the patient and to implement therapy as planned. Evaluation of baseline adherence to treatment among patients with rheumatoid arthritis allows to develop an optimal plan for follow-up and treatment control.

show abstract

Section: материалы и методыunclassified

unclassified

See 1 more Smart Citation

Problems of treatment adherence in patients with rheumatoid arthritis and comorbidity

Никитина

Жданов

Мелехина³

et al. 2020

Arhivʺ vnutrennej mediciny

Self Cite

View full text Add to dashboard Cite

show abstract

“…У пациентов с РА отмечается высокий риск преждевременной смертности в результате развития различных осложнений, в том числе и сердечно-сосудистых [5,6]. Одной из наиболее актуальных коморбидных ассоциаций при РА является хроническая сердечная недостаточность (ХСН), являющаяся исходом многих ССЗ [7,8].…”

unclassified

Evaluation of the relationship of immuno-inflammatory process with dyslipidemia and myocardial morphofunctional parameters in patients with chronic heart failure on the background of rheumatoid arthritis

Ankudinov

Калягин

2020

Naučno-praktičeskaâ revmatologiâ

View full text Add to dashboard Cite

Objective. To evaluate the relationship between the manifestations of the immune-inflammatory process with dyslipidemia and morphofunctional parameters of the myocardial state in patients with chronic heart failure (CHF) with a preserved left ventricular ejection fraction (CHF-SFV) against the background of seropositive rheumatoid arthritis (RA).Subjects and methods. The study involved 57 women with CHF-SFV, formed as a result of coronary heart disease and/or hypertension. All patients had functional class I and II according to NYHA. All patients were divided into comparable groups: the first group included 31 patients with a combination of CHF and seropositive RA of radiological stage I-III, the second group included 26 patients without RA. Patients with RA had a low and moderate degree of activity according to DAS28. The Diagnosis of CHF was verified by ESC (European Society of Cardiology) criteria, the diagnosis of RA – by EULAR/ACR criteria (2010). The therapy was in line with current clinical recommendations. Methotrexate was used as a basic anti-inflammatory drug in patients with RA. The average dosage was 12,9±2,5 mg/week. In the study groups, a comparative analysis of the main laboratory and instrumental indicators used in the diagnosis and monitoring of CHF, as well as the relationship of manifestations of the immunoinflammatory process with dyslipidemia and indicators of diastolic myocardial dysfunction was performed. Results. The level of total cholesterol in the CHF group without RA averaged 4,4±0,9 mmol/l and 5,2±2,2 mmol/l in the CHF and RA group (p=0,09); triglycerides – 1,9±0,7 and 1,5±0,9 mmol/l (p=0,3); low-density lipoproteins (LDL – C)-2,6±0,8 and 3,1±1,1 mmol/l (p=0,04); high – density lipoproteins (HDL-C) – HDL) – 1,3±0,2 and 1,3±0,1 mmol/l, respectively (p=0,7). In the group of CHF on the background of RA, a direct relationship between the intake of methotrexate (the average dose was 12,9±2,5 mg/week) and the level of HDL-C: R=0,3; R2=0,1; F=0,9; (p=0,01). In the group of CHF and RA, there was a statistically significant relationship between the ratio of transmittal flow parameters with the level of DAS28 and RF: R=0,5; R2=0,3; F=2,6 (p=0,04).Conclusion. Against the background of the immuno-inflammatory process caused by RA, a significant increase in the level of LDL was detected, which can negatively affect the course of dyslipidemia in patients with CHF-SFV. There was an increase in the concentration of HDL on the background of treatment with methotrexate in the group of CHF-SFV and RA. A direct correlation of the ratio of parameters of the transmittal flow with the RF and DAS28 levels was found. This relationship may affect the progression of left ventricular diastolic dysfunction in the group of CHF and RA, but prospective studies are needed to clarify its role.

show abstract

“…Нельзя не учиты-вать и тот факт, что у больных РА часто выявляется сопут-ствующая патология, которая также может повышать риск возникновения ОП и переломов. Так, по данным отечест-венных одномоментных исследований, 72-87% пациентов с РА имели коморбидные состояния или заболевания [24][25][26].…”

unclassified

The Risk of Osteoporotic Fractures in Patients With Rheumatoid Arthritis: Results of the Program «osteoscreening Russia»

Никитинская¹,

Торопцова²,

Демин³

et al. 2018

rsp

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) and the use of glucocorticoids (GCs) are proven risk factors for osteoporosis (OP) and osteoporotic fractures (OPF). There are also other reasons for increased fracture risk in RA.Objective: to determine the rate of RA in an epidemiological sample of persons aged 50 years and older and to identify those in need of antiosteoporotic therapy among the patients with RA in order to prevent OPF.Subjects and methods. The epidemiological sample included 18,018 people aged 50 years and older (13,941 women and 4,077 men; mean age, 62±10 years). The survey consisted of a unified questionnaire, measurement of daily dietary calcium intake, and calculation of a 10-year fracture risk using the FRAX® algorithm.Results and discussion. The prevalence of RA in the epidemiological population sample aged 50 years and older was 1.7% (1.9% in women and 1.2% in men; p=0.0047). The mean FRAX® values for major OPF in RA patients were significantly higher than those in non-RA individuals: 18.4±10 and 13.2±7.9%, respectively (p=0.0001) for women and 8.9±6.4 and 6.2±3.7%, respectively (p=0.0001) for men. 42% of the patients with RA were at high risk for OPF. Thus, 48% of the women with RA had FRAX® values above the therapeutic intervention threshold; and the non-RA group needed antiosteoporotic therapy significantly less (31%; p=0.00001). At the same time, the detection rate of high-risk OPF in men with and without RA did not differ significantly (8 and 5%, respectively; p>0.05). The most common risk factors (RFs) for OP and OPF in RA patients included previous fractures (33%), secondary causes of OP (30%), GC use (18%), and, additionally, smoking (33%) in male patients with RA. The female patients with RA significantly more frequently took GCs (17%) and had other secondary causes of OP and OPF (33%) than those without RA (7.7% (p=0.0001) and 23% (p=0.0004, respectively). The male patients with RA versus to the population-based control showed significant differences when they only used GCs (20 and 5%, respectively; p = 0.0001); the remaining RFs were encountered at the same frequency. Less than half of the normal daily calcium intake was observed in 20% of men and 16% of women (p=0.53).Conclusion. 42% of the RA patients aged 50 years and older were at high risk for OPF and needed antiosteoporotic therapy. Every third woman with RA had at least one other comorbidity or condition associated with the increased risk of OPF. In the male patients with RA, the FRAX® algorithm could reveal only 8% of persons at high risk for fractures, while 58% of them had two or more additional RFs that can negatively affect bone mineral density and increase the risk of fracture. To identify those who require prevention and treatment of OP and OPF, it is preferable to perform bone densitometry of the axial skeleton among male patients with RA.

show abstract

Comorbidity in Patients With Rheumatoid Arthritis

Cited by 12 publications

References 17 publications

Problems of treatment adherence in patients with rheumatoid arthritis and comorbidity

Problems of treatment adherence in patients with rheumatoid arthritis and comorbidity

Evaluation of the relationship of immuno-inflammatory process with dyslipidemia and myocardial morphofunctional parameters in patients with chronic heart failure on the background of rheumatoid arthritis

The Risk of Osteoporotic Fractures in Patients With Rheumatoid Arthritis: Results of the Program «osteoscreening Russia»

Contact Info

Product

Resources

About