Rheumatoid arthritis and traditional cardiovascular risk factors: actual aspects of real clinical practice

Трухан, Д. И.; Багишева, Н.В.; Belus, K. D.

doi:10.26442/20751753.2020.1.200052

Cited by 5 publications

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“…Данная проблема актуальна не только в медицинском, но и в социально-экономическом аспекте, поскольку значимо увеличивает количество госпитализаций и летальных исходов, о чем свидетельствуют данные многочисленных эпидемиологических исследований. Так, около 80% случаев смерти, ассоциированных с язвенной болезнью, приходится на пациентов, принимающих НПВП, а ежегодные затраты на лечение осложнений со стороны ЖКТ вследствие приема препаратов группы НПВП составляли около 4 млрд долларов в конце прошлого века [7][8][9][10][11][12][13].…”

Section: актуальные аспекты лекарственной безопасности при использоваunclassified

Modern opportunities for treatment and prevention of NSAID-induced enteropathies

2020

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Омский государственный медицинский университет; Россия, 644043, Омск, ул. Ленина, д. 12 Резюме Нестероидные противовоспалительные препараты (НПВП) в настоящее время активно используются в реальной клинической практике и повседневной жизни при широком круге патологических состояний и заболеваний и входят в лекарственный арсенал врачей различных специальностей. Наряду с высокой фармакотерапевтической эффективностью по основным показаниям с приемом НПВП ассоциируется целый спектр различных осложнений. Особую актуальность приобретает негативное специфическое действие НПВП на слизистую оболочку желудочно-кишечного тракта. Проблема НПВП-гастропатии широко обсуждается в литературе, что во многом обусловлено возможностями ее профилактики и лечения с использованием ингибиторов протонной помпы. Вопросам НПВП-зависимого поражения кишечника в течение длительного времени уделялось значительно меньшее внимание, что может быть связано с меньшими инструментальными возможностями диагностики этих поражений и отсутствием эффективных средств для их профилактики и лечения. В представленном обзоре рассмотрены вопросы патогенеза, клиники и диагностики НПВПэнтеропатии. Ингибиторы протонной помпы эффективно предупреждают развитие диспепсии, эрозий и язв, а также желудочно-кишечных кровотечений при приеме НПВП на уровне верхних отделов желудочно-кишечного тракта, однако они малоэффективны в плане профилактики и лечения НПВП-энтеропатии. Новым подходом является использование препарата ребамипида, доказавшего свою клиническую эффективность в предупреждении НПВП-опосредованного поражения верхних и нижних отделов желудочно-кишечного тракта. В настоящее время ребамипид включен в рекомендации ведущих профильных сообществ России и рекомендован не только для профилактики и лечения НПВП-индуцированных поражений ЖКТ, но и в составе комплексной терапии язвенной болезни и антихеликобактерной терапии. В представленном обзоре рассмотрены исследования, свидетельствующие о эффективности и безопасности ребамипида для лечения и профилактики НПВП-энтеропатии.

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Section: актуальные аспекты лекарственной безопасности при использоваunclassified

Modern opportunities for treatment and prevention of NSAID-induced enteropathies

2020

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“…However, musculoskeletal damage is not the only manifestation of RA. A chronic disease flowing can be accompanied by skin lesions (20% of patients), eye lesions (10%), gastrointestinal tract damage (hardly ever primary, more often due to drug treatment), lungs (usually asymptomatic -50%, and 10% of patients have clinical manifestations), vascular, and cardiovascular system lesions (about 50% of patients) [4][5][6]. Kidney and nervous systems lesions are diagnosed as solitary, and their reasons become because of small vessel lesions (vasculitis), which lead the organ dysfunction development such as glomerulonephritis, nephropathy, dementias, ischaemic neuropathies, and myelopathies [4,5].…”

Section: Introductionmentioning

confidence: 99%

Peripheral blood lymphocytes apoptosis role in rheumatoid arthritis progressing

Aringazina,

Seitmaganbetova,

Mussina

et al. 2023

J CLIN MED KAZ

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Rheumatoid arthritis (RA) is an autoimmune, chronic, and genetically linked inflammatory lesion of joint tissues that is accompanied by extra-articular systemic pathologies. The disease progression leads to joints immobilization, and eventually, the patient's disability occurs approximately ten years from the first clinical manifestation. RA pathogenesis involves various mechanisms: specific joint-related damage, nonspecific adaptive, and vessel-related pathological changes. Our research aimed to study the role of peripheral blood lymphocyte apoptosis in RA pathogenesis. We have analyzed research data from Google Scholar, PubMed, Web of Science, and Scopus databases to investigate the role of lymphocyte apoptosis in RA progression. Clinical manifestations in RA are caused by autoreactive T- and B-lymphocyte activity supported by humoral and cellular immune factors activity. Disease pathogenesis is caused by an imbalance in the process of programmed cell death (apoptosis): a proportion of immune cells are rapidly destroyed. In contrast, apoptosis is inhibited in the other classes of immune cells. High infiltration of the joint by autoreactive sensitized lymphocytes worsens the patient's condition. Apoptosis inhibition is especially noticeable in the early stages of RA and correlates with the concentration of the anti-apoptotic molecule Bcl-2 in the synovia. Activating the apoptotic destruction of lymphocytes (by drug action) allows a positive therapeutic effect and sustained remission. However, it should be noted that genetic factors play a significant role in the onset, progression and drug response of RA. In addition, environmental and behavioral factors can activate RA progression and influence treatment efficacy.

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Prediction of Cardiovascular Diseases in Women With Rheumatoid Arthritis

Osipova,

Starodubova

2024

Kardiologiia

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Aim. To develop prognostic models for arterial hypertension (AH) and atherosclerosis based on studying the totality and significance of traditional and disease-mediated risk factors (RFs) in women with rheumatoid arthritis (RA).Material and methods. 223 female patients with RA aged 54.9±2.1 years were evaluated at the premises of the polyclinic of the Gulla Municipal Hospital #4 (Barnaul), the "Health Center", the City Rheumatology Department of the polyclinic, and the Hospital Department in 2016-2019. Statistical analysis was performed using Excel Microsoft Office 2007, Statistica 6.0 and 10.0, and SigmaPlot 12.5 software packages. Multivariate regression analysis was used for studying the attributes influencing the development of AH and atherosclerosis in RA and for constructing predictive models. ROC analysis was used to determine the quality of the developed models. Differences were considered statistically significant at p<0.05.Results. The following RFs predominating in the onset of disease were identified: traditional (hyperglycemia, obesity, increased diastolic BP (DBP), tachycardia, dyslipidemia); disease-mediated (ESR, fibrinogen, C-reactive protein (CRP), rheumatoid factor, cyclic citrullinated peptide antibodies, moderate and high DAS-28 activity), and psychosocial (stress, anxiety, depression, sleep disorders). The highest RF incidence and their combinations were determined with a RA duration of more than a year: traditional (obesity, hyperglycemia, increased systolic BP (SBP)), and decreased glomerular filtration rate; and disease-mediated (prednisolone treatment). A highly sensitive model for AH screening was developed that included a combination of RFs: disease-mediated (RA duration, CRP); traditional (improper diet, low physical activity, history of early cardiovascular diseases, increased SBP and DBP, preeclampsia and/or eclampsia, early menopause, older age, dyslipidemia); psychosocial (anxiety, depression), and a high salt-taste threshold. A highly sensitive model was developed for probable prediction of multifocal atherosclerosis in RA in women. The model includes a complex of risk factors: disease-mediated (RA activity by DAS-28, CRP, fibrinogen, ESR, dose-dependent prednisolone treatment); traditional (AH, SBP, waist circumference, heart rate, early menopause, preeclampsia and/or eclampsia, age 55 years and older, dyslipidemia); and psychosocial (sleep disorders, depression).Conclusion. Algorithms for early prevention of AH and atherosclerosis were developed with consideration of identified predictors and proposed prediction models for women with RA.

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Rheumatoid arthritis and traditional cardiovascular risk factors: actual aspects of real clinical practice

Cited by 5 publications

References 0 publications

Modern opportunities for treatment and prevention of NSAID-induced enteropathies

Modern opportunities for treatment and prevention of NSAID-induced enteropathies

Peripheral blood lymphocytes apoptosis role in rheumatoid arthritis progressing

Prediction of Cardiovascular Diseases in Women With Rheumatoid Arthritis

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