[Combined basic therapy of rheumatoid arthritis with methotrexate and plaquenil].

AIM: To compare efficacy of basic RA treatment with methotrexate+plaquenil and basic monotherapy with methotrexate. MATERIAL AND METHODS: Two groups of rheumatoid arthritis (RA) patients were studied: group 1 (n = 82) received combined basic treatment with methotrexate (7.5 mg/week) in combination with plaquenil (0.2 ?mg/day); group 2 (n = 60) received methotrexate monotherapy according to the same scheme; all the patients received also diclofenak in a dose 100 mg/day; low-dose glucocorticosteroids were given to 36 and 24 patients, respectively. To improve methotrexate tolerance, all the patients took folic acid (1-2 mg/day 5 days a week). Efficacy of the treatment was evaluated by regression and final value of inflammation activity. RESULTS: 6-month treatment produced in groups 1 and 2 good effect in 27.6 and 21.4%, satisfactory effect--in 65.5 and 66.6% patients, respectively. No effect was seen in 6.8 and 11.9% patients, respectively. A good effect was achieved in group 1 in 73.3 +/- 5.4 days; in group 2--in 93.7 +/- 5.9 days (p < 0.05). In 12 months good and satisfactory effects persisted. Side effects occurred with the same frequency in both groups primarily in those who did not take folic acid. CONCLUSION: Combined basic therapy of RA with methotrexate and plaquenil was more effective than monotherapy with methotrexate because it produced good effects more frequently and earlier while no response was seen less often.

[The clinical aspects of the diagnosis of rheumatoid arthritis]. / Klinicheskie aspekty diagnostiki revmatoidnogo artrita.

Altogether 212 patients aged 16 to 73 years with rheumatoid arthritis (RA) lasting 3 months to 32 years were examined. Of these, 78 patients had grade I, 111 grade II, and 23 grade III disease activity. 34 patients had stage I, 76--stage II, 56--stage III, and 24--stage IV disease. In 22 patients, roentgenography failed to reveal pathology of the joints. The reference group comprised 65 patients suffering from gouty arthritis, 46 having osteoarthrosis deformans with phenomena of secondary synovitis, 30 with Bekhterev's disease, 10 with systemic lupus erythematosus, 6 with Reiter's disease, 5 with psoriatic arthropathy, and 50 with non-rheumatic diseases. When trying the diagnostic criteria for ARA (revised in 1987), criteria 1-4 and 7 were found to be most sensitive (from 88.2 to 93.8%), criteria 5 and 6 appeared most specific (100 and 98.6%, respectively). The specificity of the remaining criteria ranged from 85.4 to 96.3%. The use of the revised criteria for ARA in clinical practice was dictated by the necessity of improving RA diagnosis.

[Fibrinolytic activity of the blood and synovial fluid in patients with rheumatoid arthritis with systemic manifestations]. / Fibrinoliticheskaia aktivnost' krovi i sinovial'noi zhidkosti u bol'nykh revmatoidnym artritom s sistemnymi proiavleniiami.

Indices of fibrinolytic blood and synovial fluid activity were investigated in 75 and 25 patients with proved sero-positive rheumatoid arthritis (RA) with systemic manifestations. Changes in the parameters of the fibrinolytic system in the patients suffering from RA with systemic manifestations were regarded as symptoms of the chronic intravascular coagulation syndrome. They could play a pathogenetic role in the time course and progression of rheumatoid inflammation.

[Fibrinolytic activity of the blood and synovial fluid in patients with rheumatoid arthritis]. / Fibrinolitichaskaia aktivnost' krovi i sinovial'noi zhidkosti u bol'nykh revmatoidnym artritom.

A study of the blood fibrinolytic activity (BFA) in 95 patients with rheumatoid arthritis (RA) and in their 120 relatives and of the fibrinolytic activity of the synovial fluid (FASF) in 26 RA patients showed BFA and FASF suppression in most of them. A high activity of the contact factors and high concentrations of fibrinogen degradation products were revealed in the synovial fluid. BFA and RASF changes can contribute to the progression of rheumatoid synovitis.

[Erroneous prescription of rumalon to rheumatoid arthritis patients]. / Oshibochnoe naznachenie rumalona bol'nym revmatoidnym artritom.

The author describes 2 cases of erroneous prescription of rumalon to patients with rheumatoid arthritis (RA), as a result of which in one of the patients oligoarthritis arthritis while in the other one the typical seropositive slow-progressing rheumatoid arthritis transformed to RA with systemic manifestations.