rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2018-346-350rsp-2570Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHВлияние частоты приема нестероидных противовоспалительных препаратов на рентгенологическое прогрессирование сакроилиита у пациентов с ранним аксиальным спондилоартритомIMPACT OF THE FREQUENCY OF USING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS ON THE RADIOGRAPHIC PROGRESSION OF SACROILIITIS IN PATIENTS WITH EARLY AXIAL SPONDYLOARTHRITISРумянцеваД. Г.RumyantsevaD. G.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

rumiantceva01@gmail.comДубининаТ. В.DubininaT. V.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ЭрдесШ. Ф.ErdesSh. F.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation201815072018563346350Copyright © Румянцева Д.Г., Дубинина Т.В., Эрдес Ш.Ф., 20182018Румянцева Д.Г., Дубинина Т.В., Эрдес Ш.Ф.Rumyantseva D.G., Dubinina T.V., Erdes S.F.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2570

Цель исследования – сравнить влияние постоянного приема нестероидных противовоспалительных препаратов (НПВП) и их приема в режиме «по требованию» на активность и рентгенологическое прогрессирование раннего аксиального спондилоартрита (аксСпА).

Материал и методы

Материал и методы. В исследование включались пациенты из когорты КоРСАр, удовлетворяющие критериям аксСпА ASAS 2009 г. В настоящий анализ вошли 68 больных, наблюдавшихся не менее 24 мес. Средний возраст на момент включения в исследование составил 28,5±5,8 года, средняя продолжительность заболевания – 24,1±15,4 мес, 63 (92,6%) больных были позитивны по HLA-B27. Пациенты были разделены на две группы: в первой (n=35) больные получали НПВП постоянно в течение периода наблюдения в максимальных терапевтических дозах, во второй (n=33) – НПВП назначались «по требованию» в зависимости от наличия и выраженности боли в спине.

Результаты и обсуждение

Результаты и обсуждение. В первой группе спустя 2 года наблюдения медиана стадии рентгенологической оценки сакроилиита (СИ) не изменилась и осталась равна 4 баллам, во второй группе данный показатель за наблюдаемый период достоверно увеличился с 3 до 4 баллов (р<0,05). Исходно группы пациентов не различались по уровню С-реактивного белка (СРБ), индексам ASDAS-СРБ и BASFI, однако индекс BASDAI был выше в первой группе (р<0,05). Число пациентов с активным СИ по данным магнитно-резонансной томографии (МРТ) и степень его выраженности достоверно не различались в обеих группах. Через 2 года все пациенты сохранили низкую активность заболевания согласно ASDAS-СРБ, BASDAI и уровню СРБ, также данные показатели достоверно не различались в обеих группах, индекс BASFI стал выше в первой группе. Число пациентов с активным СИ по данным МРТ снизилось, но различий между группами выявлено не было.

Заключение

Заключение. У пациентов с ранним аксСпА постоянный прием НПВП позволяет в большей степени замедлить рентгенологическое прогрессирование, чем прием «по требованию». 

Objective

Objective: to compare the impact of continuous or on-demand use of nonsteroidal anti-inflammatory drugs (NSAIDs) on the activity and radiographic progression of early axial spondyloarthritis (axSpA).

Subjects and methods

Subjects and methods. The investigation enrolled patients from the early spondyloarthritis cohort who met the 2009 Assessment of Spondyloarthritis International Society (ASAS) criteria for axSpA. This analysis included 68 patients who had been followed up for at least 24 months. The mean age at the time of inclusion in the investigation was 28.5±5.8 years; the mean disease duration was 24.1±15.4 months; 63 (92.6%) patients were HLA-B27-positive. The patients were divided into two groups: 1) 35 patients used NSAIDs at maximum therapeutic doses continuously during the follow-up period; 2) 33 patients received these drugs on-demand, depending on the presence and severity of back pain.

Results and discussion

Results and discussion. After 2-year follow-up, the median stage of radiographic sacroiliitis (SI) in Group 1 was unchanged and remained equal to 4; that in Group 2 in this period significantly increased from 3 to 4 scores (p < 0.05). At baseline, the patient groups did not differ in C-reactive protein (CRP) levels, the Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), and the Bath Ankylosing Spondylitis Functional Index (BASFI); however, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was higher in Group 1 (p < 0.05). The number of patients with active SI, as evidenced by magnetic resonance imaging (MRI), and the degree of its severity did not differ significantly between groups. After 2 years, all the patients retained low disease activity according to ASDAS-CRP, BASDAI, and CRP levels; and these measures did not differ significantly between groups either; the BASFI became higher in Group 1. MRI findings indicated that the number of patients with active SI decreased, but no differences were found between the groups.

Conclusion

Conclusion. In patients with early axSpA, the continuous intake of NSAIDs can slow radiographic progression to a greater extent than their on-demand use. 

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The authors declare that there are no conflicts of interest present.