USE OF THE DISEASE-MODIFYING DRUG LEFLUNOMIDE IN PATIENTS WITH RHEUMATOID ARTHRITIS
DOI:
https://doi.org/10.32782/health-2024.2.1Keywords:
rheumatoid arthritis, arthritis syndrome, T-cells, extraarticular displays, morning constraint.Abstract
This paper is dedicated to an urgent problem of modern medicine, namely the treatment of rheumatoid arthritis. According to the literature, the activation and proliferation of the T-cell and macrophage pool with the involvement of synoviocytes/chondrocytes plays an important role in the pathoge. It is known that the mechanism of action of the active metabolite leflunomide (A771726) blocks dihydroorotate dehydrogenase, which in turn inhibits pyrimidine synthesis in rapidly dividing cells (activated T-lymphocytes, macrophages). As a result, leflunomide blocks the main link in the pathogenetic mechanism of rheumatoid arthritis development and progression.nesis of rheumatoid arthritis, which in turn leads to the destruction of articular cartilage. The study involved 52 patients with rheumatoid arthritis. This group of patients was represented predominantly by women (46 patients); the majority were seropositive for rheumatoid factor (RF) – (42 patients). The drug was prescribed according to the standard scheme: 100 mg/day for the first 3 days, then 20 mg/day. The dose was temporarily reduced in some patients to 10 mg/day in case of intolerance reactions. The effectiveness of leflunomide was evaluated in relation to the effect on indicators of RA activity and progression. In 30% of patients, the duration of rheumatoid arthritis at the time of leflunomide prescription was less than 3 years, in 46% – 4–10 years, and in 24% – more than ten years. Radiological stages III–IV were recorded in 70% of patients. With the exception of 2 patients with rheumatoid arthritis activity of grade II–III, and according to the criteria of the European Anti-Rheumatic League using the Disease activity score (DAS), all patients had moderate to high RA activity. In 35 patients (70%), arthritic manifestations were detected before the start of therapy. The rapid effect of action of Leflunomide is certain with the reliable decline of indexes of arthritis syndrome and laboratory indexes of activity of inflammation in 1 month of treatment.
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