Dynamics of concomitant therapy in children with juvenile idiopathic arthritis treated with etanercept and methotrexate
|
01.10.2019 |
Alexeeva E.
Dvoryakovskaya T.
Denisova R.
Sleptsova T.
Isaeva K.
Chomahidze A.
Fetisova A.
Mamutova A.
Alshevskaya A.
Gladkikh V.
Moskalev A.
|
Pediatrics and Neonatology |
10.1016/j.pedneo.2019.02.003 |
2 |
Ссылка
© 2019 Background: Both the steroid- and NSAID-sparing effects of biologics in juvenile idiopathic arthritis (JIA) treatment are key aspects of the dynamics of patient's condition. The proper selection of biologics enables maximum treatment effectiveness and reduction of the dosage of concomitant therapy. Our aim was to study the dynamics of concomitant therapy during etanercept (ETA) and methotrexate (MTX) treatment in patients with JIA. Methods: This analysis included 215 JIA patients (63.3% females) showing sufficient response to main therapy. One hundred patients received MTX as main therapy, 24 received ETA monotherapy, and 91 received ETA þ MTX combination therapy. The dynamics of concomitant therapy were analyzed after 1 month, every 3 months during the first year, and every 6 months during the long-term follow-up (up to 5 years). Results: At the baseline, 24 (11.2%) patients received concomitant oral glucocorticoids (orGCs) and NSAIDs; the remaining 191 (88.8%) patients were treated with concomitant NSAIDs only. Within 1-year treatment, NSAIDs were discontinued in 162 (75.3%) patients. There were no significant differences in the dynamics of withdrawal of NSAIDs in patients who received and did not receive concomitant MTX. However, the percentage of treatment discontinuation in the MTX group was significantly lower compared to the other two groups (p < 0.001). Oral GCs were discontinued completely in 4 children (16.7%), and the dose of oral GCs was reduced in another 4 patients (16.7%). By the end of the follow-up period, 44 of 115 patients (38.3%) treated with ETA in combination with any concomitant therapy could switch to ETA monotherapy. Conclusion: Therapy with ETA makes it possible to reduce the dosage or completely discontinue most concomitant medications (orGCs, NSAIDs, MTX) in a significant percentage of patients. This reduces the risk of development of NSAID- and GC-induced pathological conditions, while the effectiveness of therapy of the underlying condition remains high.
Читать
тезис
|
NSAID-induced enteropathy: The current state of the problem
|
01.01.2018 |
Svistunov A.
Osadchuk M.
Kireeva N.
Hudarova A.
Achkasov E.
|
Terapevticheskii Arkhiv |
|
0 |
Ссылка
© 2018 Media Sphera Publishing Group. All rights reserved. The review analyzes the main etiological and pathogenetic mechanisms of the development of NSAID-enteropathy. Particular attention is paid to the role of intestinal microbiota in the manifestation and progression of NSAID-enteropathy. The special role of probiotics in the prevention and treatment of NSAIDs enteropathy is considered.
Читать
тезис
|
Association of rheumatologists of Russia, Russian Society for the study of pain, Russian gastroenterology association, Russian scientific medical society of therapists, association of traumatologists and orthopedists of Russia, Russian Association of pall
|
01.01.2018 |
Karateev A.
Nasonov E.
Ivashkin V.
Martynov A.
Yakhno N.
Arutyunov G.
Alekseeva L.
Abuzarova G.
Evseev M.
Kukushkin M.
Kopenkin S.
Lila A.
Lapina T.
Novikova D.
Popkova T.
Rebrov A.
Skorobogatykh K.
Chichasova N.
|
Nauchno-Prakticheskaya Revmatologiya |
|
8 |
Ссылка
© 2018 Ima-Press Publishing House. All Rights Reserved. In 2015, the experts from various medical associations of Russia elaborated the clinical guidelines "Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice". These guidelines were drawn up to improve the use of NSAIDs, our country's most popular agents to treat pain in acute and chronic diseases. The main purpose of this paper was to reduce the frequency of potentially dangerous class-specific adverse events (AE) that may arise from the use of NSAIDs. To do this, the authors proposed a NSAID choice algorithm based on the assessment of risk factors for AE, the individual characteristics of various representatives of this drug group, and the possibility of prevention of AE. Since then, new data on the efficacy and safety of NSAIDs have been obtained. This has necessitated the revision and addition of a number of provisions in the 2015 guidelines. It seems that the new version of the guidelines, which has been drawn up based on the analysis of a large number of clinical and epidemiological studies, their meta-analysis, by taking into account the clinical experience and opinion of the world's leading experts, presents more fully the main aspects of the use of NSAIDs in real clinical practice. The guidelines are intended for physicians of all specialties.
Читать
тезис
|