Recent studies have shown that heart disease in patients with rheumatoid arthritis occurs according to various data in 20-100% of cases. Hypertension is often the first objectively detectable marker of cardiovascular pathology in patients with rheumatoid arthritis. Hypertension in patients with rheumatoid arthritis usually becomes an active initiator and accelerator of the progression of atherosclerosis and remodeling of the left ventricle. Cardiac remodeling in patients with hypertension and in patients with rheumatoid arthritis, combined with hypertension is a significant factor that affects to the quality of life and prognosis and requires careful study of this problem. The purpose of the work was to study the systolic function and morphological parameters of the left ventricle in patients with rheumatoid arthritis in combination with hypertension and to establish indicators associated with high cardiovascular risk. Material and methods. The main group of patients consisted of 93 patients with rheumatoid arthritis of moderate activity in combination with hypertension stage II. The second group included 45 patients with essential hypertension stage II. The control group had 31 almost healthy people. An ultrasound examination of the heart was performed with studying of systolic function and the main morphological parameters of the left ventricle. Results and discussion. We found a significant increase in the left ventricle myocardial mass index by 11.97% in patients with rheumatoid arthritis in combination with hypertension compared to the patients with essential hypertension and by 30.1% compared to the control group. We also detected the significant increase of the interventricular septum thickness by 9.02%, the posterior wall of left ventricle – by 5.51%, and the relative wall thickness of left ventricle – by 6.0% in patients with rheumatoid arthritis in combination with hypertension compared to the patient with essential hypertension. There was a significant increase in end-diastolic volume by 8.64%; end-systolic volume – by 12.95%; and a decrease of ejection fraction by 2.5% in patients with rheumatoid arthritis in combination with hypertension with m SCORE >4 points compared to the corresponding indicators of patients with m SCORE ≤4 points. The study showed that the most common type of left ventricle remodeling was concentric left ventricle hypertrophy (79% of patients) in patients with rheumatoid arthritis with hypertension. In addition, the subgroup of patients with m SCORE >4 points left ventricle myocardial mass and left ventricle myocardial mass index were by 15.01% and 14.86% significantly higher than the corresponding indicators in the subgroup of patients with m SCORE ≤4 points. Conclusion. The patients with rheumatoid arthritis in combination with hypertension showed an association between increasing of the left atrium size and the volume parameters of the left ventricle, and the presence of fluid in the pericardial cavity. This was manifested by the left atrium size increase by 10.65%, end-diastolic volume – by 8.62%, end-systolic volume – by 12.2% and the ejection fraction decrease by 2.23% in patients with fluid versus to a subgroup of patients without fluid in the pericardium

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Primary Sjögren’s syndrome (pSS, Sjögren’s disease) is a systemic autoimmune disease which develops in previously healthy individuals and characterized by damage to exocrine glands, mainly lacrimal and salivary glands, with gradual formation of their secretory insufficiency and various systemic manifestations. According to EULAR recommendation (2019) therapeutic management of pSS bases on symptomatic treatment of sicca syndrome and broad-spectrum immunosuppression for systemic manifestations. The perspective group for the treatment of autoimmune disease is Janus kinase inhibitors, which can block the signals from biologically active molecules (interferons, erythropoietins and cytokines) and providing a response to these target cell signals. Therefore, the use of JAK inhibitors in patients with pSS requires clinical confirmation of effectiveness. The article described the clinical case of the positive effect of tofacitinib with methotrexate combination in the treatment of patient with pSS. A 55-year-old female with sicca syndrome (confirmed by Schirmer’s test), arthralgia, low-grade fever, weight loss and a positive test for the detection of specific antibodies (SS-A/Ro > 240 units/ml, SS-B/La 94 units/ml) was diagnosed with pSS. The total score of EULAR Sjögren’s syndrome disease activity index (ESSDAI) was 9 (activity grade II). The treatment included symptomatic methods of sicca syndrome correcting (replacement therapy with artificial tear preparations and chewing gums with xylitol) in combination with immunosuppressive therapy. The addition of tofacitinib 5 mg twice daily to methotrexate (10 mg weekly) has been shown to significantly reduce disease activity after 6 months of treatment (ESSDAI = 0).

BackgroundOA osteoarthritis is a heterogeneous group of diseases of different etiology with similar biological, morphological, clinical manifestations and consequences, which are based on damage to all articular structures (cartilage, subchondral bone, synovial membrane, ligaments, capsules, periarticular muscles). A key role in the pathogenesis of OA is played by an increase in the catabolic activity of various cytokines, as well as matrix metalloproteinases (MMP) of the cartilage itself.ObjectivesThe purpose of the study was to compare the dynamics of pain syndrome (based on Western Ontario McMaster Osteoarthritis Index – WOMAC pain subscale) during 180-day treatment with undenatured collagen type II (UC-II) and glucosamine and chondroitin (G + Ch) combination in patients with Grade II knee OA.MethodsPatients with Grade II knee OA were investigated. 20 patients were administrated the UC-II during 180-day period, 20 patients took the combination of G + Ch during the same period. WOMAC pain subscale was used to evaluate the effectiveness and was completed before the start of therapy and after 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 90, 120, 150, 180 day of treatment. Visual analog scale (VAS) from 0 to 10 was used for assessment the WOMAC subscale by patient. In this abstract we presented the dynamics of pain during walking and nocturnal pain.ResultsThe initial data of pain during walking and nocturnal pain in UC-II group were 6.29±0.37 and 4.35±0.59, after treatment – 2.99±0.37 (-52.46 %, р <0.05) and 1.7±0.41 (-60.92 %, р <0.05). In G + Ch group initial data were 7.05±0.43 and 4.85±0.69, after therapy – 3.85±0.35 (-45.39 %, р <0.05) and 2.85±0.51 (-41.24 %, р <0.05). Comparing groups demonstrated the better results according to decrease of WOMAC pain subscale in the group of UC-II: reduce of pain during walking by 28.76 % and reduce of nocturnal pain by 67.65 % (р <0.05).The analysis of the graph of pain during walking has recorded the beginning of significant pain reducing after 30 day of treatment in both groups (Figure 1). The analysis of the graph of nocturnal pain has showed the beginning of significant pain reducing after 50 day of treatment in both groups. Dynamics of nocturnal pain reducing in the G + Ch group was more unstable with periods of reduced efficiency, while in the UC-II group the dynamics was smooth without fluctuations.Figure 1.ConclusionThe therapy of Grade II knee OA with UC-II during 180-day demonstrates the benefit in reducing of pain during walking and nocturnal pain in compare to G + Ch combination. The dynamics of nocturnal pain reducing in the UC-II group characterizes by gradual decline without significant fluctuations.References[1]Bagchi D., Misner B., Bagchi M. et al. (2002) Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration. Int. J. Clin. Pharmacol. Res., 22, 101-10.[2]Robinson W.H., Lepus C.M., Wang Q. et al. (2016) Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat. Rev. Rheumatol., 12(10), 580-592. doi:10.1038/nrrheum.2016.136.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

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