Certain Indicators of Diclofenac Sodium Pharmacokinetics in Patients with Rheumatoid Arthritis Considering Comorbide States.

Introduction: Much attention is paid to pharmacokinetic (FK) researches for studying the processes of supply, distribution, biotransformation and excretion of medications at the present time, as well as identifying links between medical substances concentration and (or) its metabolites in biological fluids and tissues, and its pharmacological effect. In the treatment of rheumatoid arthritis (RA), non-steroidal anti-inflammatory drugs (NSAID) are widely used for a symptom therapy, where Diclofenac Sodium (DS) is most commonly prescribed. Duration of anti-inflammatory effect, effectiveness of NSAID in whole are directly dependent on the level of effective concentration of medications and circulation duration in blood in free form. The Aim of the present research work is to study in a comparative aspect certain indicators of Diclofenac Sodium pharmacokinetics in patients with rheumatoid arthritis with gastric microbiocenosis disorders (gastric dysbiosis) and without disorders (without dysbiosis). Materials and Method: 38 patients at the age from 18 to 60 years were examined, with I-II-III degree of disease activity. In addition to the general clinical examination, an immune-enzyme method and urease test were carried out to determine Helicobacter Pylori and highly effective liquid chromatography to determine Diclofenac pharmacokinetics. Results: Conducted researches and analysis of their results indicate that in conditions of rheumatoid arthritis, particularly, in the presence of comorbid states, there is a decrease in the metabolism rate and an extension of NSAID half-excretion period, which increases the risk of side effects, especially to the gastrointestinal tract, and significantly affects the disease course and the results of the treatment. Conclusion: In conditions of rheumatoid arthritis with comorbid states, there is more frequent occurrence of the NSAID side effects. Research conducted and analysis of their results indicate that in conditions of rheumatoid arthritis, particularly at comorbid states, there are reasonable changes in the NSAID pharmacokinetics. The decreasing of metabolic rate and the extension of the NSAID half-excretion increases the risk of side effects, especially on the side of the GIT, which significantly affects the disease course and results of the treatment. This circumstance dictates the need to take these results into account in the treatment of the studied pathology and in the development of a personalized approach to the treatment of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]