Objective. To study possibility of using blood rheological parameters as markers of inflammation and cardiovascular risk (CVR) in pts with psoriatic arthritis (PA). Material and methods. 130 pts (51 male and 79 female) with PA aged from 39 to 48 years (mean age 43 years) without clinical signs of coronary heart disease (CHD) and stroke were included. Duration of PA varied from 2 months to 42 years (mean 7 years), duration of psoriasis (PS) – from 5,5 to 26 years (mean 15 years). Main measures of erythrocyte aggregation (EA) including Kt (c-1) – total speed of erythrocytes aggregates formation, T (c) – time of linear erythrocytes aggregates formation, I2,5 [%] – parameter characterizing durability of most large erythrocytes aggregates, β (c-1) – hydrodynamic durability of erythrocytes aggregates were evaluated in erythroaggregometer by registration of intensity of inverse light scattering from blood sample. PA activity was measured with DAS4. CHD development risk score was determined considering traditional CVR factors – age, total cholesterol (TCH) and high density lipoproteins (HDLP) level, systolic blood pressure (SBP), presence of diabetes, smoking. Serum C-reactive protein (CRP) and fibrinogen concentration was measured with standard methods. Correlation analysis was performed with Spearman range correlation coefficient (R), Mann-Whitney (U) test was used for groups comparison and p<0,05 was considered as statistically significant level. Results. EA disturbances corresponding to 2nd stage of severity were present in all pts with PA. Significant correlation between EA parameters (T , Kt, I2,5, β) and DAS4 (R=-0,32/0,32/0,33/0,25, p<0,001) as well as significant correlation of all EA parameters (T , Kt, I2,5, β) with laboratory inflammation markers: CRP (R=-0,37/0,41/0,46/0,32), ESR (R=-0,34/0,35/0,42/0,26) and most strong – with fibrinogen (R=-0,55/0,55/0,49/0,32) were revealed. Significant correlations of all EA parameters and fibrinogen with CVR level was found in all pts (R=-0,31/0,35/0,23/0,22, p<0,001). In women relationship between EA parameters, fibrinogen and CVR level was stronger (R=-0,42/0,41/0,40/0,27). In men correlation between EA parameters, fibrinogen and CVR was not found. Conclusion. EA parameters in PA are biomarkers of inflammation and CVR.

Objective. The purpose of the current study was to investigate nimesulide effects on prostaglandin E 2 concentration in blood serum and some parameters of the cardiovascular system in pts with RA during a 6-month period. Materials and methods. 40 RA pts were studied, 20 of them took 200 mg of nimesulide per day (24 hours) in combination with low doses of metatrexate (7.5-10.0 mg per week). The pts were studied for 6 months. The content of E2 prostaglandin in blood serum was evaluated and estimated by means of the immuneenzymic method in 20 pts who took 200 mg of nimesulide per day (24 hours) in comparison with 20 pts who took 100 mg of sodium diclofenac per day. The cardiovascular system was evaluated and estimated by means of screening examinations and after the 6-month treatment period by means of 24-hour monitoring of arterial blood pressure, ECG-monitoring and echocardioscopy. Results. In case of the nimesulide treatment the above RA pts did not show reliable reduction of PGE- 2 in blood serum as compared with sodium dicofenac after a 5 day and the 6-month treatment. This showed the selective effect of nimesulide in relation to COX-2. As far as the parameters of the cardiovascular system are concerned, no negative dynamics were revealed at the background of nimesulide treatment . It was revealed that nimesulide is quite effective and has good tolerance.

Results of treatment of 76 pts with knee osteoarthritis with native drug Adgelon (glycoprotein possessing biological activity at super low doses) are presented. WOMAC index, Lequesne functional index and SF-36 questionnaire show analgesic effect and quality of life improvement after 6 intra-articular adgelon injections during 3 weeks. Subsequent follow up for 2 months revealed aftereffect of the drug.

Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA) with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II). Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks). Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

Lethality of pts with rheumatoid arthritis (RA) exceeds mortality values in general population. Possibility of disease modifying anti-rheumatic drugs (DMARD) influence on RA pts lethality has been widely discussed lately in scientific works. Objective. To determine possible lethality diminishment in Russian population of RA pts with one of biological drugs TNFα antagonist adalimumab. Material and methods. Model construction is based on the fact of lethality dependence on pt functional state assessed by HAQ. Model simulating progression of functional disability in pts with RA visiting medical institutions of Russia was made (RAISER study). 3 model variants for imitation of consecutive change of DMARDs including adalimumab were done. First consecution assessed DMARD change in the next chain: adalimumab-methotrexate-sulfasalazine-leflunomide-azathioprine-cyclosporine-palliative therapy. Second consecution: adalimumab administration after failure of first 3 DMARDs. Third consecution considered only change of synthetic DMARDs without adalimumab inclusion. Model imitated participation of 3000 pts in every consecution. Prognosis horizon was 12 years. Age of pts and initial HAQ distribution were get from results of epidemiological RAISER study. Calculation was done on the base of elevation of standardized lethality level (SLL) in population of RA pts in average from 135% to 300%. SLL values from 80 to 320% were used depending on functional disability degree with converting to Russian values of age-specific lethality coefficient for 1999. Results. Lethality in treatment consecutions including adalimumab was significantly lower. To the end of 12th year in group not using adalimumab, using it at once and using it after 376 DMARDs respectively 65,1%, 71,6% and 71,1% of pts were still alive. Conclusion. Significant decrease of lethality with adalimumab inclusion in consecution of DMARD change during treatment of RA pts was demonstrated with imitation modeling method.