Osteoarthritis (OA) is currently considered to be one of the most widespread diseases. Its main clinical symptoms include pain and dysfunction of joints. In the present review of the foreign and domestic literature, the questions of pathogenesis and risk factors underlying the development of osteoarthritis are discussed. The understanding of OA pathogenesis have altered essentially in the recent years which made necessary the search for the novel approaches to the treatment of this pathology. According to the modern views of OA origin and progression, its therapy should be based on the application of the combination of medicamentous and non-medicamentous modalities including, in particular, collective and individual activities focused on the implementation of the programs of therapeutic physical training as an obligatory component of ОА prophylaxis and treatment. The present review gives evidence of the feasibility of the application of the methods of cryotherapy and radonotherapy for the management of the patients suffering from osteoarthritis. It is emphasized that many recent publications report extensive investigations of the clinical and pathogenetic aspects of the application of these methods for the combined regenerative treatment of the patients presenting with gonarthrosis. The influence of cryotherapy and radonotherapy on the neuroendocrine and immune systems is discussed with special reference to the possibility of regulation of the metabolic processes and retardation of inflammation. It is concluded that the introduction of the above methods into the compulsory individual program for the regenerative treatment of patients presenting with osteoarthritis is pathologically substantiated since it greatly contributes to the reduction of pain and retardation of the progress of the disease. The main pharmaceutical preparations for the OA treatment remain to be slow-acting symptomatic medicines possessed of the chondro-protective effect.

О р и г и н а л ь н ы е и с с л е д о в а н и я ФГБУ «Научноисследовательский институт ревматологии им. В.А. Насоновой» РАМН,

No abstract

Background Work productivity loss and activity impairment is one of most important RA consequences and leads to considerable financial losses. Objectives To study the effect of RA clinical characteristics on work productivity of patients (pts). Methods 137 RA pts were enrolled: 116 women and 21 men. Average age was 52.03+13.17 yrs. Age at the onset of the disease was 42.12+14.43 yrs. 59 pts had paid employment. Joint damage was estimated according to Sharp Score in van der Heijde modification (total vdH-Sharp score) and RA activity – according to DAS28. Quantitative assessment of functional statute was done by using Health Assessment Questionnaire (HAQ). Study of work productivity and regular activities was done by questionnaire Work Productivity and Activity Impairment-Specific Health Problem Questionnaire (WPAI-SHP). Average value of DAS28 4.8+1.4, HAQ – 1.42+0.82, 60.6% were seropositive by RF, 79.6% - positive by ACCP. Median total vdH-Sharp score – 83.0[59.0-118.0]. 54.8% of pts at the moment of examination used methotrexate, 19.7% - biological agents, 8,8%> leflunomide. Results Mean absenteeism was 28.2% (mediana 2.6%[0-44.4%]). In 28 out of 59 working pts the value were equal to 0. Mean presenteeism was 54.8%±34.4%. Regular activities determined in all pts was decreased by 53.6±25.7%. Association between clinical data and values of index WPAI was determined by using Spearman correlation factor. Absenteeism negatively correlated with RA duration (R=0.26). DAS28 index directly correlated to all WPAI indices: absenteeism – R=0.27; presenteeism – R=0.63; overall work impairment - R=0.46; activity impairment - R=0.52. Most strong correlation was found with pain intensity assessment by patient (by WAS), values of correlation were higher than 0.5. HAQ index was not connected with absenteeism while its association with presenteeism overall work impairment, activity impairment was high (R=0.64; R=0.40; R=0.61 correspondingly). Most expressed associations were determined between index of patient physical condition – PCS SF-36 as compared to mental. No correlation of WPAI with total vdH-Sharp score was found. Conclusions RA clinical characteristics strongly correlated to work productivity of pts determined by WPAI-SHP. RA severity determines dropping of absenteeism as well as presenteeism in RA pts. Disclosure of Interest None Declared