Objective: a retrospective analysis of the results obtained by typing HLA-A, -B antigens and HLA DRB1 allele groups in patients with rheumatoid arthritis (RA) in the Rostov population.Materials and methods: typing of patients with rheumatic inflammatory diseases who were on inpatient treatment in the rheumatology department of the SBI “OKB No. 2” was carried out in the LITT SBI RO "BTS" in 2019-2020. 41 patients (9 men, 32 women, median age — 42 years) were diagnosed with RA. All patients were typed by HLA-DRB1 alleles by real-time polymerase chain reaction with DNA-TECH reagents (Russia). To isolate DNA, a set of Sample-Rapid-Genetics was used by NPO DNA Technology LLC. 39 patients were typed аccording to HLA-A, -B. Typing was carried out by a standard lymphocytotoxic test with DILEN reagents (Czech Republic). Lymphocytes were isolated in a density gradient of “Lympholot”, DILEN company. The control group consisted of healthy residents of the Rostov population (donors of the hematopoietic stem cell registry).Results: a retrospective analysis showed that HLA DRB1*04 occurs in 46.3% of the Rostov population with RA, in 61.1% of the seropositive RA group (control — 20%). There was a decrease in the frequency of HLA DRB1*13 (9.7%) compared to the control (24.4%).Conclusions: the high level of reliability (p<0.001) of the increase in the frequency of HLA DRB1*04 alleles confirms their associative relationship with RA in the Rostov population. A decrease in the frequency of HLA DRB1*13 indicates the protective function of these alleles in RA. Typing results are important for early diagnosis of RA.
В выборе терапевтической тактики остеоартрита следует использовать персонифицированный подход в зависимости от распространенности патологического процесса и наличия фоновых заболеваний. Согласно российским и зарубежным рекомендациям в качестве базисной фармакотерапии остеоартрита с первых этапов используются группы препаратов замедленного действия, структурно модифицирующих хрящ (symptomatic slow-active drug in osteoarthritis – SYSADOA). Целью данного исследования была оценка эффективности и безопасности терапии инъекционным хондропротектором у пациентов с первичным и вторичным остеоартритом различной локализации после стационарного курса базисной терапии ревматоидного артрита, анкилозирующего спондилита или обострения первичного остеоартрита. В исследование было включено 30 пациентов с ревматическими заболеваниями с установленным диагнозом первичного или вторичного остеоартрита на фоне ревматоидного артрита и анкилозирующего спондилита. После проведенного в стационаре курса базисной терапии на амбулаторном этапе пациенты получали инъекционный хондропротектор по 1 мл в/м 1 раз в сутки в течение 20 дней согласно инструкции по медицинскому применению. Комплексное обследование пациентов было проведено на стационарном этапе. Выраженность болевого синдрома оценивалась по 100-миллиметровой визуально-аналоговой шкале. Степень контроля над болью пациенты оценивали через 30 ± 7 дней от начала лечения. Терапия инъекционным хондропротектором у больных первичным и вторичным остеоартритом различной локализации позволяет добиться статистически значимого уменьшения выраженности болевого синдрома и улучшения функционального состояния суставов у большинства пациентов. Терапия характеризуется высоким профилем безопасности и хорошей переносимостью. Она позволяет не только эффективнее купировать болевой синдром у больных с первичным и вторичным остеоартритом, но и повысить безопасность проводимого лечения за счет снижения риска развития нежелательных явлений на фоне приема нестероидных противовоспалительных препаратов, что особенно важно, учитывая коморбидный профиль большинства пациентов с ревматическими заболеваниями суставов. In choosing the therapeutic tactics of osteoarthritis, a personalized approach should be used, depending on the prevalence of the pathological process and the presence of background diseases. According to Russian and foreign recommendations, groups of delayed-acting drugs that structurally modify cartilage are used as the basic pharmacotherapy of osteoarthritis from the first stages (symptomatic slow-active drug in osteoarthritis – SYSADOA). The aim of this study was to evaluate the efficacy and safety of therapy with an injectable chondroprotector in patients with primary and secondary osteoarthritis of various localizations after a stationary course of basic therapy for rheumatoid arthritis, ankylosing spondylitis, or exacerbation of primary osteoarthritis. The study included 30 patients with rheumatic diseases diagnosed with primary or secondary osteoarthritis against the background of rheumatoid arthritis and ankylosing spondylitis. After a course of basic therapy in the hospital at the outpatient stage, patients received an injectable chondroprotector 1 ml intramuscularly 1 time per day for 20 days according to the instructions for medical use. A comprehensive examination of patients was carried out at the inpatient stage. The severity of the pain syndrome was assessed using a 100 mm visual analogue scale. The degree of pain control was assessed by patients 30 ± 7 days after the start of treatment. Therapy with an injectable chondroprotector in patients with primary and secondary osteoarthritis of various localization makes it possible to achieve a statistically significant decrease in the severity of pain syndrome and improve the functional state of the joints in most patients. The therapy is characterized by a high safety profile and good tolerability. It allows not only to more effectively relieve pain in patients with primary and secondary osteoarthritis, but also to improve the safety of treatment by reducing the risk of adverse events while taking non-steroidal anti-inflammatory drugs, which is especially important given the comorbid profile of most patients with rheumatic joint diseases.
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