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Objectives: This article reports 1-year clinical outcomes of patients with rheumatoid arthritis (RA) receiving abatacept (ABA) therapy. Materials and methods: Patients (n=91) with high RA activity (DAS28 = 5.1 ± 1.0) and an inadequate response on synthetic DMARDs (mainly methotrexate, 70.3%) and biologics (mainly TNF-α inhibitors, 93%) were included in the study. The majority of patients were middle-aged (49 ± 13.5) womens, RF (72.5%) and ACPA (77%) positive, with moderate functional impairment - HAQ = 1.4 (0.9-2). ABA were administered IV, 10 mg/kg according to the standard scheme. The evaluation of the effectiveness of the therapy was carried out according to the EULAR / ACR 2011 criteria using SDAI, CDAI, HAQ and the intention to treat approach. Results: ABA led to a significant (p

Diagnosis of rheumatoid arthritis (RA) at the beginning of the disease is a difficult task especially due to presence of a large group of pts with “undifferentiated arthritis” (UA) i.e. with inflammation of one or more joints which does not comply with a definite nosology. According to clinical experience UA is quite a serious condition which during a year transforms in definite RA in at least one third of pts. In 2007 Van der Helm-van Mil et al. proposed special criteria (“prediction rule”) allowing predicting transforming UA intoRA by counting prognostic index (PI). PI6 means low and PI8 - high probability of RA 37development during 1 year. Objective. To assess possibility of using prognostic criteria for determination of transforma- tion of UA into RA in Russian pts. Material and methods. 93 pts (84,9% - female) with early (disease duration no more than 12 months) UA were included. Mean age was 44,3±15,2 years, mean disease duration – 128,9±82,1 days (4,3±2,7 months). 59,1% of pts had olygoarthritis, 26,9% were rheumatoid factor seropositive, anti-cyclic citrullinated peptide antibodies (ACCP) were revealed in 29%. Examination with above mentioned methods to specify the diagnosis was performed trice during 12 months: at baseline, after 6 and 12 months. Results. During a year of follow up RA developed in 39(41,9%) pts. Mean value of PI was 5,18±2,48 (median 5,02 [3,01; 7,02]). PI values in pts with disease transformation into RA during a year were significantly higher (6,55±2,33) than in the rest of pts (4,18±2,1), p

Objective. To assess frequency of immunogenetic (HLA-DRB I allels) and immunologic - anti-cyclic citrullinated peptide antibodies (ACCP), IgM rheumatoid factor (RF) - parameters and their significance as markers of early rheumatoid arthritis (RA). Material and methods. HLA-DRB 1 alleles, ACCP and IgM RF were evaluated in 95 pts with early RA who fulfilled ACR criteria 1987 with disease duration 2 years or less. In 85,3% of them disease duration was

Objective. To assess efficacy melatonin administered for correction of sleep disturbances in pts with rheumatoid arthritis (RA). Material and methods. 3-weeks randomized controlled study of melatonin (Melaxen, Unipharm) 3 mg/day (in the evening) in 20 RA pts with sleep disturbances was performed. Control placebo group included 10 pts comparable with study group. Effect of the drug on insomnia so as on the main clinical and laboratory indices of RA activity was scored. Results. To the end of follow up study group pts showed improvement of sleep quality in comparison with initial. Frequency of such insomnia signs as feeling of dissatisfaction with night sleep, tiredness persistence after sleep and unpleasant feelings during sleep significantly decreased. The general result of treatment with melaxen was assessed by pt and doctor as improvement or significant improvement in 47,4-63,2% of cases. Morning stiffness, swollen and tender joint counts so as pain intensity significantly decreased during treatment. Improper drug tolerability was noted in only one pt. Signs of insomnia and RA activity did not change in placebo group. Conclusion. Melatonin is an effective and safe drug for correction of sleep disturbances in RA pts. It also showed capacity to decrease inflammatory activity of RA.