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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1995-4484-2019-511-516</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-2781</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Динамика показателей липидного профиля у больных ранним псориатическим артритом на фоне терапии адалимумабом</article-title><trans-title-group xml:lang="en"><trans-title>Time course of changes in lipid profile measures in patients with early psoriatic arthritis during adalimumab therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маркелова</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Markelova</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маркелова Евгения Иннокентьевна.</p><p>115522, Москва, Каширское шоссе, 34А.</p></bio><bio xml:lang="en"><p>Evgenia Markelova.</p><p>34A, Kashirskoe Shosse, Moscow 115522.</p></bio><email xlink:type="simple">evgenia-i.m@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Новикова</surname><given-names>Д. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Novikova</surname><given-names>D. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А.</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коротаева</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotaeva</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А.</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Логинова</surname><given-names>Е. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Loginova</surname><given-names>E. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А.</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Научно-исследовательский институт ревматологии им. В.А. Насоновой<country>Россия</country></aff><aff xml:lang="en">V.A. Nasonova Research Institute of Rheumatology<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>14</day><month>11</month><year>2019</year></pub-date><volume>57</volume><issue>5</issue><fpage>511</fpage><lpage>516</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маркелова Е.И., Новикова Д.С., Коротаева Т.В., Логинова Е.Ю., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Маркелова Е.И., Новикова Д.С., Коротаева Т.В., Логинова Е.Ю.</copyright-holder><copyright-holder xml:lang="en">Markelova E.I., Novikova D.S., Korotaeva T.V., Loginova E.Y.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/2781">https://rsp.mediar-press.net/rsp/article/view/2781</self-uri><abstract><p>Пациенты с псориатическим артритом (ПсА) имеют более высокий риск развития сердечно-сосудистых заболеваний (ССЗ) по сравнению с общей популяцией. Значимый вклад в развитие ССЗ и их осложнений у больных ПсА вносят воспаление и традиционные факторы риска (ФР) ССЗ, в том числе дислипидемия. Цель — оценить динамику показателей липидного профиля у больных ранним ПсА (рПсА) на фоне терапии адалимумабом (АДА) в течение 3 мес наблюдения.</p><sec><title>Материал и методы</title><p>Материал и методы. В исследование включено 16 больных ранним ПсА (рПсА) — 11 женщин, 5 муж-чин, медиана (Me) возраста — 45,5 года, длительности заболевания — 7,7 мес. АДА вводился подкожно по 40 мг 1 раз в 2 нед в течение 3 мес. До и через 3 мес после начала терапии АДА у всех пациентов определяли индекс DAS, уровень С-реактивного белка (СРБ), традиционные ФР ССЗ, в том числе показатели липидного профиля: уровень общего холестерина (ОХС), холестерина липопротеидов низкой плотности (ХС ЛПНП), триглицеридов (ТГ), холестерина липопротеидов высокой плотности (ХС ЛПВП) и коэффициент атерогенности (КА). По шкале SCORE оценивался 10-летний риск фатальных ССЗ.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. Нарушения липидного профиля, преимущественно связанные с повышением уровня ХС ЛПНП, выявлены у 11 (69%) пациентов; 10-летний суммарный риск фатальных ССЗ по шкале SCORE был низким у 10 (62,5%) и умеренным у 6 (37,5%) больных. Выявлена корреляция исходных значений индекса DAS с ТГ (r=0,53; p&lt;0,05) и КА (r=0,57; p&lt;0,05); уровня ЛПВП с DAS (r=-0,68; p&lt;0,05), число болезненных (r=-0,63; p&lt;0,05) и припухших суставов (r=-0,65; p&lt;0,05).</p><p>Через 3 мес после начала терапии АДА у 15 (94%) больных достигнута ремиссия рПсА, у одного пациента (6%) — низкая активность заболевания. Обнаружено повышение медианы уровня ОХС с 4,9 [4,5; 5,9] до 5,5 [4,9; 6,3] ммоль/л (p=0,01) и ТГ с 0,8 [0,7; 1,4] до 1,1 [0,9; 1,4] ммоль/л (p=0,03). Не отмечено достоверной динамики уровня ХС ЛПНП, ХС ЛПВП и КА, их медианы в начале и в конце терапии составляли: 3,3 [2,8; 4,1] и 3,6 [3,3; 4,1] ммоль/л, 3,0 [1,2; 1,5] и 1,3 [1,2; 1,6] ммоль/л, 2,6 [2,3; 3,6] и 3,2 [2,4; 3,6] соответственно. Наблюдалась тенденция к нарастанию частоты нецелевых значений ОХС с 44 до 75%, ХС ЛПНП с 69 до 81%, ТГ с 12,5 до 19%, КА с 37,5 до 62,5% (p&gt;0,05).</p></sec><sec><title>Заключение</title><p>Заключение. Изменения показателей липидного профиля обнаружены у 69% больных рПсА и коррелировали с активностью заболевания. Снижение воспалительной активности на фоне терапии АДА сопровождалось увеличением уровня ОХС и ТГ.</p></sec></abstract><trans-abstract xml:lang="en"><p>Patients with psoriatic arthritis (PsA) have a higher risk of cardiovascular disease (CVD) compared with the general population. Inflammation and traditional CVD risk factors (RFs), including dyslipidemia, make a significant contribution to the development of CVD and their complications in patients with PsA.</p><sec><title>Objective</title><p>Objective: to assess the time course of changes in lipid profile measures in patients with early PsA (ePsA) during adalimumab (ADA) treatment for 3-months.</p></sec><sec><title>Subjects and methods</title><p>Subjects and methods. The investigation enrolled 16 patients (11 women, 5 men; median (Me) age, 45.5 years) with early PsA (ePsA) (disease duration, 7.7 months). ADA was administered subcutaneously at doses of 40 mg once every 2 weeks for 3 months. Before and 3 months after the start of ADA therapy, DAS, C-reactive protein levels, and traditional CVD RFs, including lipid profile measures (total cholesterol, TC, low-density lipoprotein cholesterol, LDL-C, triglycerides, TG, high-density lipoprotein cholesterol, HDL-C, and atherogenic coefficient, AC) were estimated. Ten-year risk for fatal CVD was assessed using the SCORE scale.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. Lipid profile disorders mainly associated with elevated LDL-C levels were revealed in 11 (69%) patients; according to the SCORE scale, the total 10-year risk for fatal CVD was low and moderate in 10 (62.5%) and 6 (37.5%) patients, respectively. A correlation was found between the baseline DAS and TG (r=0.53; p&lt;0.05) and AC (r=0.57; p&lt;0.05); between HDL levels and DAS (r=-0.68; p&lt;0.05), and between the number of tender (r=-0.63; p&lt;0.05) and swollen joints (r=-0.65; p&lt;0.05).</p><p>Three months after starting ADA Median level of TC increased from 4.9 [4.5; 5.9] to 5.5 [4.9; 6.3] mmol/L (p=therapy, 15 (94%) patients achieved remission of ePSA; one (6%) patient showed a low disease activity. 0.01) and TG — from 0.8 [0.7; 1.4] to 1.1 [0.9; 1.4] mmol/L (p=0.03). There were no significant changes in the level of LDL-C and HDL-C, and CA, their medians at the beginning and end of therapy were 3.3 [2.8; 4.1] and 3.6 [3.3; 4.1]; 3.0 [1.2; 1.  5] and 1.3 [1.2; 1.6]; 2.6 [2.3; 3.6] and 3.2 [2.4; 3.6] mmol/L, respectively. There was a tendency to increase the frequency of non-target TC values from 44 to 75%, LDL-C from 69 to 81%, TG from 12.5 to 19%, and AC from 37.5 to 62.5% (p&gt;0.05). </p></sec><sec><title>Conclusion</title><p>Conclusion. Lipid profile changes were found in 69% of patients with ePSA and correlated with disease activity. The lower inflammatory activity during ADA therapy was accompanied by elevated TC and TG levels.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ранний псориатический артрит</kwd><kwd>ингибитор фактора некроза опухоли а</kwd><kwd>адалимумаб</kwd><kwd>дислипидемия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>early psoriatic arthritis</kwd><kwd>tumor necrosis factor-а inhibitor</kwd><kwd>adalimumab</kwd><kwd>dyslipidemia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Yim KM, Armstrong AW. Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms. Rheumatol Int. 2017;37(1):97-105. doi: 10.1007/s00296-016-3487-2</mixed-citation><mixed-citation xml:lang="en">Yim KM, Armstrong AW. Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms. 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