Use of Nonsteroidal Anti-Inflammatory Drugs and Biological Agents for the Treatment of Axial Spondyloarthritides. Recommendations of the Spondyloarthritis Study Group of Experts, All-Russian Public Organization «the Association of Rheumatology of Russia»

Damianov

Naučno-praktičeskaâ revmatologiâ

et al. 2019

Objective: to evaluate the effect of golimumab (GLM) on endothelial vasomotor function and arterial stiffness in patients with ankylosing spondylitis (AS).Subjects and methods. A total of 42 patients with advanced-stage AS, who were older than 18 years and met the 1984 modified New York criteria with a disease duration of ≤5 years, were examined. The investigators visualized carotid arteries to determine local vascular wall stiffness, studied regional arterial stiffness to assess a pulse wave contour analysis, and a reactive hyperemia test before and after 104-week therapy.Results and discussion. RA patients without cardiovascular comorbidity were found to have signs of subclinical great artery involvement accompanied by endothelial vasoregulatory dysfunction in both the small resistance and large muscular arteries; by increases in common carotid artery (CCA) intima-media thickness (IMT) and stiffness index (SI); by rises in peripheral augmentation index (AIp), SI and reflection index (RI), the intensity of a change in which correlated with disease duration and activity assessed by ASDAS; as well as with the modified Schober test value, cervical rotation, and tragus-to-wall distance. In addition to a decrease in the Ankylosing Spondylitis Disease Activity Score (ASDAS), GML treatment in patients with AS caused a statistically significant increase in the amplitude occlusion index to the control values and a rise in the phase shift between the channels by an average of 2 times (p<0.01) as compared to the baseline values; a decrease in CCA IMT by an average by 20% (p=0.01) and in the local stiffness of the (carotid) vascular bed by 31% (p=0.01). The pulse wave contour analysis after 104-week GLM therapy revealed that AIp, SI and RI decreased by an average of 5 (р<0.001), 1.3 (р<0.01), and 2 (p<0.05) times, respectively, with the remaining statistically significant differences from the control values.Conclusion. In addition to the effectively reduced inflammatory activity, GLM therapy in patients with AS provides restoration of endothelial function in both the small resistance vessels (an increase in the amplitude occlusion index) and the large muscular arteries (a rise in the phase shift between the channels) and also has a vasoprotective effect on the wall of large elastic vessels (reductions in CCA IMT, SI, AIp, and SI) and small muscular arteries (a decrease in RI).

Section: Discussionunclassified

Effect of golimumab on endothelial vasomotor function and arterial stiffness in ankylosing spondylitis

Damianov

Naučno-praktičeskaâ revmatologiâ

et al. 2019

Naučno-praktičeskaâ revmatologiâ

“…Терапия как ББ, так и АС представляет собой крайне сложную задачу из-за многообразия клинических проявлений, каждое из которых может оказывать существенное влияние на выбор тактики лечения. Эффективность применения иФНОα при АС доказана многими рандомизированными и наблюдательными клиническими исследованиями [16]. Опыт назначения этих препаратов при ББ только накапливается, но уже сейчас имеются данные, подтверждающие их позитивное влияние на различные симптомы [17,18].…”

Section: результатыunclassified

Behcet's disease concurrent with axial spondyloarthritis: the authors' own observations

Alekberova¹,

Dubinina²,

Goloeva³

et al. 2019

Self Cite

О р и г и н а л ь н ы е и с с л е д о в а н и я В 1974 г. J. Moll и соавт. [1] впервые предложили термин «серонегативные спондилоартриты» (СпА) для обозначения группы заболеваний со схожими клиническими, рентгенологическими и генетическими признаками. Авторы акцентировали внимание на том, что префикс «спондило-» подчеркивает сильную взаимосвязь между каждым заболе-ванием из данной группы и анкилозирующим спондилитом (АС). Исходно в группу «серонегативных СпА» были включены: идиопатический АС, псориатический артрит, болезнь Рейтера, язвенный колит, болезнь Крона, болезнь Уиппла и синдром Бехчета. Спустя годы, по мере накопления знаний, изменился взгляд на нозологический состав СпА, были

“…О р и г и н а л ь н ы е и с с л е д о в а н и я Обсуждение НПВП являются препаратами первой линии как при АС [25,27], так и при нр-аксСпА. Согласно рекомендациям ASAS [27,28] и отечественных экспертов по изучению СпА [26], для больных АС постоянное применение следует считать предпочтительным, поскольку оно может обеспечить не только снижение активности заболевания [29], но и замедление прогрессирования структурных изменений за счет подавления патологической пролиферации костной ткани в аксиальном скелете. Однако до сих пор не ясно, какой режим приема НПВП предпочтителен у пациентов с ранним аксСпА.…”

Section: результатыunclassified

“…Поскольку эффективность различных НПВП при аксСпА существенно не различается [25], в данном исследовании не отдавалось предпочтений каким-либо препаратам. Мониторинг безопасности длительного применения НПВП при аксСпА проводился согласно рекомендациям российской Экспертной группы по изучению СпА [26].…”

unclassified

Impact of the Frequency of Using Nonsteroidal Anti-Inflammatory Drugs on the Radiographic Progression of Sacroiliitis in Patients With Early Axial Spondyloarthritis

Румянцева¹,

Dubinina²,

Эрдес³

2018

rsp

Self Cite

Objective: to compare the impact of continuous or on-demand use of nonsteroidal anti-inflammatory drugs (NSAIDs) on the activity and radiographic progression of early axial spondyloarthritis (axSpA).Subjects and methods. The investigation enrolled patients from the early spondyloarthritis cohort who met the 2009 Assessment of Spondyloarthritis International Society (ASAS) criteria for axSpA. This analysis included 68 patients who had been followed up for at least 24 months. The mean age at the time of inclusion in the investigation was 28.5±5.8 years; the mean disease duration was 24.1±15.4 months; 63 (92.6%) patients were HLA-B27-positive. The patients were divided into two groups: 1) 35 patients used NSAIDs at maximum therapeutic doses continuously during the follow-up period; 2) 33 patients received these drugs on-demand, depending on the presence and severity of back pain.Results and discussion. After 2-year follow-up, the median stage of radiographic sacroiliitis (SI) in Group 1 was unchanged and remained equal to 4; that in Group 2 in this period significantly increased from 3 to 4 scores (p < 0.05). At baseline, the patient groups did not differ in C-reactive protein (CRP) levels, the Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), and the Bath Ankylosing Spondylitis Functional Index (BASFI); however, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was higher in Group 1 (p < 0.05). The number of patients with active SI, as evidenced by magnetic resonance imaging (MRI), and the degree of its severity did not differ significantly between groups. After 2 years, all the patients retained low disease activity according to ASDAS-CRP, BASDAI, and CRP levels; and these measures did not differ significantly between groups either; the BASFI became higher in Group 1. MRI findings indicated that the number of patients with active SI decreased, but no differences were found between the groups.Conclusion. In patients with early axSpA, the continuous intake of NSAIDs can slow radiographic progression to a greater extent than their on-demand use.