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The lecture gives an update on adult-onset Still's disease, including that on the specific features of the clinical picture and treatment of this disease.

There are virtually no diagnostic tests that can diagnose diseases of the musculoskeletal system and connective tissue with 100% sensitivity and 100% specificity, which was the reason for making both diagnostic and classification criteria to help practitioners and investigators. The application of these criteria is discussed in the article.

The paper describes a case of infliximab-induced lupus-like syndrome in a female patient with rheumatoid arthritis and discusses the possible causes of this pathology.

The authors comment on the discussion article «Definition of the term “rheumatology”: do we need this and how do the EULAR and the ACR look at this?» by Sh. Erdes.

Objective: to evaluate of the efficacy of methotrexate (MTX) as a concentrated solution (50 mg/ml) for subcutaneous administration versus coated tablets at equal oral doses of 15 mg/week for rheumatoid arthritis (RA). Subjects and methods. The study was conducted at two centers: the V.A. Nasonova Research Institute of Rheumatology and the Saint Petersburg Medical Academy of Postgraduate Education, Federal Agency for Healthcare and Social Development. At each center, the patients were randomized into two groups: a study group and a control group. In the study group, MTX was used as a concentrated solution (50 mg/ml) for subcutaneous administration at a dose of 15 mg/week. The controls were patients with RA who took MTX as coated tablets once weekly at the same dose as used in the study group. A trend in the 28-joint disease activity score (DAS28) was a main criterion for evaluating therapy efficiency. For efficiency evaluation, other criteria were additionally used; these included disease activity assessment by a physician; functional status assessment (Health Assessment Questionnaire); C-reactive protein level. The safety of the used MTX formulations was evaluated during each visit: the patients' subjective sensations and examination and laboratory findings were kept in mind. Results and discussion. After randomization (totally at the two centers), the study group included 42 patients and the control group comprised 23. Based on 95% confidence interval for the mean, it may be concluded that the efficiency of MTX as a solution for subcutaneous administration (the study group) is no less than that of MTX as tablets (the control group). Subcutaneous MTX was shown to be associated with the lower rate of therapy correction than oral MTX; and did not differ from it in toxicity. In addition, subcutaneous MTX may noticeably reduce the need for biological agents. The final DAS28 value in the study group does not exceed that in the control group (t-test). Remission was observed only after subcutaneous administration of the drug. Conclusion. Based on the findings, it can be concluded that MTX as a concentrated (50 mg/ml) solution for subcutaneous administration may be the drug of choice for the treatment of patients with active RA.

The discussion provides evidence for the long-felt need to standardize the terms reflecting the harm of drugs.

The paper considers discussion ideas about the possible causes of medicine uncertainty that arose in the era of digital technologies and information flooding.

Objective : to evaluate the safety of treatment with methotrexate (MT) solution for subcutaneous injections in patients with rheumatoid arthritis (RA). Subjects and methods . 237 RA patients enrolled in the study within the REMARCA protocol were given MT solution for subcutaneous injections (Metoject) to assess the standard parameters of therapy safety. Results. Overall, adverse events (AE) were noted in 49 (21%) patients. In 30 (30%) of them RA duration was less than 6 months (Group 1) and in 19 (14%) – more than 6 months (Group 2), in most cases average MT dose was 20.9±3.45 mg/week. Elevation of alanine aminotransferase and aspartate aminotransferase levels, nausea, postinjection reactions, alopecia, rash, infections, and leukopenia, were common (> 1%, but

The paper discusses whether it is expedient to use the standards approved by the editorial staff of a number of medical journals for original articles on the therapeutic effect of drugs, including antirheumatic agents since this is of importance for the analysis of their safety.

Ingibitory faktora nekroza opukholi α (FNO α) – infliksimab, adalimumab i etanertsept – k aprelyu 2009 g. poluchili bolee 2 mln bol'nykh vo vsem mire. Vse eti preparaty okazalis' odinakovo effektivny (okolo 60% bol'nykh otvetili na lechenie) pri revmatoidnom artrite (RA), ankiloziruyushchem spondilite (AS), psoriaze, psoriaticheskom artrite i odobreny dlya lecheniya etikh boleznei [1, 2]. Odnako ikh ispol'zovanie mozhet byt' svyazano s tselym ryadom neblagopriyatnykh reaktsii, odnoi iz kotorykh yavlyaetsya obostrenie ili razvitie novykh sluchaev psoriaza [3].

Objective: to estimate the advantages and disadvantages of using the injectable formulation of methotrexate (MT) (Methoject (MTJ)) in rheumatoid arthritis (RA) in clinical practice. Subjects and methods. A 24-week open-label controlled randomized comparative study evaluated the therapeutic and side effects of MTJ and methotrexate tablets in RA and clarified whether MTJ treatment might be continued if its tabletted formulation was discontinued because of adverse reactions. Results and discussion. MTJ was found to be more effective than the tabletted formulation of MT and as a whole; and following 3-month therapy, more patients receiving MTJ achieved an ACR20 response. The advantage of MTJ was also retained 6 months after therapy. Higher transaminase levels were noted in 2 patients, one in each group. Switching from MT to MTJ noticeably reduced the number of adverse reactions in the majority of patients from an additional group. Conclusion. As compared to MT, MTJ used in RA patients is more effective when given in an equivalent dose, exerts a therapeutic effect more rapidly, and induces adverse gastrointestinal reactions less frequently.