Updated Eular Guidelines for the Management of Gout. Comments on Certain Items

Елисеев, М. С.

doi:10.14412/1995-4484-2017-600-609

Cited by 16 publications

(2 citation statements)

References 98 publications

(121 reference statements)

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“…Диагноз подагры подтверждали в соответствии с кли ническими рекомендациями, утвержденными Советом директоров Американской коллегии ревма- тологов и Исполнительным комитетом Европейской антиревматической лиги (ACR/EULAR) 2015г [12]. Эхокардиографическое исследование (ЭхоКГ) выполняли по стандартной методике на аппарате "Atrida pro Toshiba" в режимах одномерного (М) и двухмерного (В) сканирования с использованием импульсноволнового, непрерывно-волнового допплера и цветового допплеровского картирования [13].…”

Section: Discussionunclassified

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Kushnarenko¹,

Александровна²,

Мишко³

et al. 2020

Russ J Cardiol

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Aim. To study the effect of ivabradine and bisoprolol on cardiac hemodynamics and diastolic remodeling in gout patients with coronary artery disease and hypertension and without left ventricular systolic dysfunction.Material and methods. The open randomized parallel clinical trial of 35 men with intercritical gout at the age of 41,4±3,3 years, with class II-III stable angina, hypertension and sinus rhythm without data suggestive of heart failure was performed. All patients included in the study were randomly divided into two groups: eighteen patients took bisoprolol at a dose of 2,5 to 10 mg/day, 17 subjects received bisoprolol 2,5 mg/day with ivabradine (Coraxan, SERVIER, France) 5 mg 2 times a day. Adjustment of the therapy was carried out every 2 weeks until the target heart rate (HR) was reached at 55-60 beats/min and then remained unchanged until 12 weeks of therapy. All patients underwent echocardiography, 24-hour Holter and central aortic blood pressure monitoring, and 3-minute cycle ergometer test with a power of 25, 50, 75 and 100 watts.Results. There was a comparable decrease in the maximum and minimum 24-hour average heart rates in patients receiving only bisoprolol and those taking bisoprolol+ivabradine. Patients taking bisoprolol+ivabradine had a decrease of central systolic and diastolic blood pressure (BP). Pulse pressure in the bisoprolol group increased by 17,7% (p=0,02), and when ivabradine was added, on the contrary, it decreased by 7,0% (p=0,04). Twelve-week therapy with beta-blockers and ivabradine was accompanied by an effective decrease in the pulse wave velocity in both groups (p<0,05). All gout patients did not have a decrease of systolic function and there was an improvement in diastolic remodeling with beta-blockers and ivabradine therapy.Conclusion. The results obtained indicate that the addition of ivabradine to bisoprolol leads to an effective decrease in heart rate, an improvement in arterial stiffness and exercise tolerance. Combination therapy with ivabradine is accompanied by an improvement in clinical outcomes using lower doses of bet-blockers, which requires further study and a double-blind controlled study.

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Section: Discussionunclassified

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Kushnarenko¹,

Александровна²,

Мишко³

et al. 2020

Russ J Cardiol

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“…Это позволяет предположить, что носительство данного полиморфизма может приводить к усилению активации NLRP3, способствующему обострению артрита под влиянием колеба- Недавно было показано, что гибридный белок, представляющий собой молекулу α1-антиприсина, соединенную с Fc-фрагментом IgG, подавляет развитие острого подагрического артрита, что ассоциируется с увеличением продукции ИЛ1β и ИЛ1Ра [17]. Средствами стандартной терапии подагры являются нестероидные противовоспалительные препараты (НПВП), колхицин и глюкокортикоиды (ГК) [18][19][20]. Однако возможность применения стандартной терапии может быть лимитирована наличием противопоказаний, таких как артериальная гипертензия, сахарный диабет, сниженная функция почек, заболевания желудочно-кишечного тракта [21,22].…”

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Therapy with canakinumab for gout

Елисеев¹,

Насонов

2019

Naučno-praktičeskaâ revmatologiâ

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Научно-практическая ревматология. 2018;56(Прил. 4):41-48 41 1 115522 Москва, Каширское шоссе, 34А; 2 119991 Москва, ул. Трубецкая, 8, стр. 2 1 V.A. NasonovaЗначительная часть пациентов с подагрой имеют противопоказания к приему нестероидных противовоспалительных препаратов, колхицина и глюкокортикоидов; нередко подобная терапия бывает неэффективна, особенно у пациентов с тяжелой тофусной подагрой, что осложняет лечение острого приступа артрита в подобных случаях, предполагая потребность в использовании других методов терапии. В последние годы разработано несколько лекарственных препаратов, механизм противовоспалительного действия которых связан с ингибицией интерлейкина 1 (ИЛ1), играющего ключевую роль в развитии острого приступа артрита при подагре. На сегодняшний день наиболее хорошо изученным и единственным зарегистрированным препаратом для купирования острого приступа артрита является канакинумаб, рекомендуемый для применения в ситуациях, когда иные варианты терапии неприемлемы. Несмотря на эти ограничения, использование ингибиторов ИЛ1, в частности канакинумаба, представляется многообещающим в силу высокой эффективности препарата, возможности использовать его у пациентов с коморбидными заболеваниями, а также благоприятного влияния на риск сердечно-сосудистых заболеваний. Ключевые слова: подагра; канакинумаб; интерлейкин 1β. Для ссылки: Елисеев МС, Насонов ЕЛ. Применение канакинумаба при подагре. Научно-практическая ревматология. 2018;56(Прил. 4):41-48. THERAPY WITH CANAKINUMAB FOR GOUT Eliseev M.S. 1 , Nasonov E.L. 1, 2A significant part of patients with gout has contraindications to taking nonsteroidal anti-inflammatory drugs, colchicine and glucocorticoids. Such therapy is often ineffective, particularly in patients with the severe tophaceous gout what hampers treatment of acute arthritis attack assuming the need for other methods of therapy. During the last years several medications have been introduced the mechanism of anti-inflammatory action of which is associated with inhibition of interleukin 1 (IL1) playing a key role in the development of acute gouty arthritis. To date, the most well-studied and the only registered drug for relief of acute arthritis attack is canakinumab, recommended for use in situations where other therapy options are unacceptable. Despite these limitations, the use of IL1 inhibitors, in particular canakinumab, seems promising due to the high efficiency of the drug, the ability to use it in patients with comorbid diseases, as well as a favorable effect on the risk of cardiovascular disease.

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Assessment of the risk of developing type 2 diabetes mellitus in patients with gout based on the FINDRISС scale

Zhelyabina¹,

Елисеев²,

Чикина³

et al. 2021

Diabetes mellitus

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BACKGROUND: Gout is associated with a high incidence of type 2 diabetes mellitus (T2DM).AIM: To calculate the risk of T2DM on the FINDRISС scale, to assess the sensitivity and specificity of the scale in patients with gout based on the results of prospective follow-up.MATERIALS AND METHODS: A prospective single-center study included 444 patients with gout over 18 years of age (49 women, 395 men) without diabetes. The duration of follow-up ranged from 2 to 8 years. Initially, the risk of developing diabetes mellitus 2 was calculated according to the Russian version of the FINDRISС scale. The risk of developing T2DM was assessed as «low» with a total score (CC) <7 points, slightly increased — from 7 to 11 points, moderate — from 12 to 14 points, high — from 15 to 20 points, and very high — ≥20 points. To assess the validity of using the FINDRISС scale, an analysis of sensitivity, specificity, construction of the ROC curve with the determination of the area under the curve was carried out. The presence and number of subcutaneous tophi, the number of arthritis attacks over the last year, the number of affected joints during the illness, serum levels of creatinine, uric acid, hs-CRP, glycated hemoglobin were determined.RESULTS: Over 5.66 [2.69; 7.64] years of follow-up, T2DM developed in 108 patients (24.3%). On the FINDRISС scale, low risk was found in 16 (4%), slightly increased in 187 (42%), moderate in 98 (22%), high in 80 (18%), very high in 63 (14%). The most common risk factors (RF) for T2DM included in FINDRISС were BMI> 25 kg / m2 — 85.6% of patients, taking antihypertensive drugs — 81.3% of patients, age over 45 years in 70.5% of patients. The sensitivity and specificity of the FINDRISС scale were 52.8% and 66.3%, respectively. According to these data, the quality of the model was assessed as moderate. 9% vs 31.1% (p = 0.014)), serum MK level ≤300 μmol / L. Developed type 2 diabetes 33.3% of patients with moderate / high / very high risk 18.1% of patients with low or slightly increased risk (p = 0.0002).CONCLUSION: The FINDRISС scale can have sufficient sensitivity (52.8%) and specificity (66.3%) and can be used to calculate the risk of T2DM in patients with gout.

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Updated Eular Guidelines for the Management of Gout. Comments on Certain Items

Cited by 16 publications

References 98 publications

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Therapy with canakinumab for gout

Assessment of the risk of developing type 2 diabetes mellitus in patients with gout based on the FINDRISС scale

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