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Objective. To assess the efficacy and safety of amtolmetin guacil (AMG) in patients with knee joint osteoarthritis (KJOA) and associated dyspepsia in real clinical practice.Methods. 220 patients with KJOA with severe pain syndrome in KJ ≥ 40 mm in VAS and dyspepsia were included in the observation study. AMG was administered at a dose of 600 mg twice daily for 28 days. Patients had three visits: before starting treatment, on Day 14 ± 3 (visit 2), on Day 28 ± 3 (final visit) to assess the pain dynamics (according to VAS), stiffness and functional activity according to WOMAC index, general health assessment (according to VAS) and a quantitative assessment of dyspepsia (SODA index).Results. Of 219 patients, about 72.5% reported pain reduction from 65 to 27 mm at the end of the study. All indicators of three scales of the WOMAC index decreased statistically significant (р

The review considers the problem of comorbidity of osteoarthritis (OA) and depression. The latter in OA patients is shown to be commonly a component of the well-known triad of pain – depression – sleep disorders, frequently determining the functional abilities and quality of life. The presence of anxiety and depression may increase the risk for poor outcomes of arthroplasty. Environmental stressors in patients require a biopsychosocial approach, by determining the possibilities of drug and non-drug treatment. However, despite the relatively large number of works dedicated to the problem of depression in patients with OA, there are many unsolved questions regarding both its role in the development of the disease and approaches to therapy.

Objective: to investigate the efficacy and tolerability of amtolmetin guacil (AMG; Niselat®, Dr. Reddy's Laboratories Ltd, India) versus previous therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis (OA) and signs of dyspepsia.Subjects and methods. The open-label observational study included 220 patients aged 30–65 years who suffered from knee OA and intense pain during NSAID intake and had symptoms of dyspepsia in the absence of contraindications to the use of AMG. Among the comorbidities that generally occurred in 68% of the patients, there was a preponderance of hypertension (42%), lower extremity varicose veins (6.4%), and diabetes mellitus (6%). Treatment efficacy was evaluated using three domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), by also taking into account pain intensity and general health assessment on the visual analogue scale. A Severity of Dyspepsia Assessment (SODA) scale was used to rate dyspepsia.Results and discussion. AMG had a marked analgesic effect confirmed by 40% or more pain reduction that occurred in 72.5% of the patients. The high analgesic effect of AMG was confirmed by a statistically significant (p

Aim. To study attitude towards the disease in rheumatic patients during antidepressant therapy and during further follow-up. Subjects and methods. Examinations were made in 122 patients with degenerative joint and vertebral column disease (DJVCD) and in 30 patients with rheumatoid arthritis (RA) and concomitant affective disorders during antidepressant therapy for 3 months. Results. Statistically significant differences were found between all components of the type of attitude towards disease (TATD) in patients with DJVCD or RA before the use of antidepressants. In the patients with RA, the mean value of adaptive types of TATD was significantly lower and that of disadaptive types significantly higher. After 3 months of treatment, the TATD profiles came closer. Only three components (anosognosia, hypochondriasis, and dysphoria) in the pattern of TATD remained significantly different after 6-month therapy. Conclusion. According to the TATD data, both the patients with DJVCD and those with inflammatory diseases of the locomotor apparatus showed unidirectional changes in attitude towards disease with a significant increase in the adaptive components and a reduction in the disadaptive ones.

Certolizumab pegol (CZP) is a new drug from the group of tumor necrosis factor a inhibitors. The efficacy and safety CZP in the treatment of rheumatoid arthritis (RA) have been studied in the international 52-week RAPID-1 and 24-week RAPID-2 clinical trials that studied the use of CZP in combination with methotrexate (MTX) in patients with active RA unresponsive to MTX. The study populations of the RAPID 1 and RAPID 2 trials constituted the major portion of Russian patients (11.8 and 18.4%, respectively), including that in the prolonged open-labeled phases. The results of using CZP in Russian patients in the RAPID trials showed that they displayed a highly stable response to treatment and a rapidly developing clinical effect, that a therapy response could be predicted in the first 12 weeks, and that the incidence of local postinjection reactions was low.

Objective. To study comorbid depression influence on course of rheumatoid arthritis (RA)and antidepressants efficacy in such pts. Material and methods. 70 pts with RA (all women) fulfilled the 1987 ACR criteria with comorbid depression disturbances were included. 30 from them received course of treatment with antidepressants (main group). 20 refused proposed therapy (main control group). 20 RA pts without depression were included in an additional control group which was also followed up. Hamilton scales of depression and anxiety were used. Results. Baseline clinical measures did not significantly differ between study groups. Antidepressants application in main group pts was accompanied by significant improvement of tender and swollen joint count, morning stiffness duration, pain intensity (score),functional disability index (FDI) after 3 months (

To standardize general quality of life (QL) questionnaire SF-36 scales and calculate population scale measures depending on respondents sex and age. Material and methods. Standardized QL measures of all SF-36 questionnaire scales were calculated in 3400 respondents of 5 centers of Russian Federation stratified according to sex and age. Results. Male population had better QL measures than female (p

Цель. Установить связь эффективности лечения стационарных больных с заболеваниями опорно-двигательного аппарата с некоторыми личностными характеристиками их лечащих врачей по оценке пациентов. Материал и методы. 181 больной с заболеваниями опорно-двигательного аппарата (большинство ревматоидным артритом и остеоартрозом) и 6 лечащих врачей разного стажа работы и квалификации. Использовалась методика «Идеальный —реальный врач» Результаты. Рассчитанные средние показатели негативизма к врачу и показатели обобщенной конфликтности в диаде «врач — больной» различались среди оценивавшихся ревматологов, при этом крайние значения у разных ревматологов — существенно. Наибольшие расхождения между идеальным и реальным врачом отмечены по такой характеристике, как настроение врача. Не установлено связи между показателями конфликтности, возрастом и стажем работы ревматолога, а также его квалификацией. Врачи ранжировались по их успешности лечебной деятельности (на основании числа позитивных и негативных результатов по оценке больного), а также в зависимости от степени показателей конфликтности и выраженности некоторых личностных особенностей (ум, внимание, терпение, настроение, отзывчивость, общительность, твердость). С помощью метода ранговой корреляции Спирмена установлено, что показатели конфликтности в диаде «врач — больной» и такими качествами врача, как внимательность и терпеливость, вместе с эффективностью лечения формируют констелляцию признаков, определяющую успешность врача и его рейтинг в глазах пациента. Вывод. Подтверждена важность включения ряда личностных качеств в понятие «профессиональная компетентность» врача, обосновывана необходымость неформального подхода к оценке его квалификации с учетом не только специальных знаний, навыков и владения профессиональными «технологиями», но и возможностей его взаимодействия с пациентом.

Objective. To estimate influence of educational programm on the level of knowledge of patients with RA about the disease, readiness for compliance, quality of life, efficiency of therapy and attitude to the disease. Methods. 103 women with RA were included in the study. They were divided into four groups: a control group, "passive" school and "active" school groups and a group with individual training (33, 21, 29 and 20 pts respectively). At the discharge from hospital and 12 months later medical estimation of patient knowledge and 10 test tasks were performed including "Index of biotic satisfaction" (N.Panin), quality of life estimation on visual analogous scale, a self-rating "of health and happiness" (Dembo- Rubinstein), "Level of social frustration" and "type of attitude to illness" (SPb Bechterev’s institute), readiness for complianse (original questionnaire). Results. At the time of discharge and in after 12 months test tasks and medical estimation of pts knowledge indices in "active" school and individual training groups were significantly higher, than in of control group and group of "passive" school (p < 0,001). The collective medical assessment demonstrated a correlation between treatment efficacy and the method of information transfer (p=0.29: p < 0,05). The quality of life correlates with the method of training according to all assessment techniques. Estimation of training method influencing on compliance provided similar results (p: = 0.45; p < 0,05). In groups of "active" school and individual training the number of pts who strictly followed the regimens of physical rehabilitation increased. Conclusion. Our data confirm the necessity of purposeful and systematic educational training in RA. The active methods and individual training promote the achievement of best results