Background Diseases that cause inflammation such as rheumatoid arthritis (RA) can increase the risk of development of secondary osteoarthritis (OA). In the treatment of patients with RA no attention is paid to treatment of associate secondary OA.
Objectives The aim of the study was to estimate the efficacy of therapeutic approach with the use of inhibitor of interleukin-1 in the complex therapy of secondary OA of the knee in patients with RA.
Methods 150 patients (139 females and 11 mails) with secondary OA of the knee in RA were enrolled in the trial (mean age 56,5±12,2) with the duration of the disease 5-15 years). All of them had the definite diagnosis RA according to the criteria of ACR/EULAR. Patients were divided into 2 groups. 75 patients (group 1) underwent complex drug therapy (methotrexate (MTX) 10-15 mg per week and inhibitor of interleukin-1 (IL-1) (diacerein in doses 50 mg 2 times per day). 75 patients (group 2) received only basic treatment (MTX 10-15 mg per week). We evaluated joint pain on 100-mm visual analog scale (VAS), indexes WOMAC, Lequesne, Diseases Activity Score (DAS28), Health Assessment Questionnaire (HAQ) before treatment and after 6 months.
Results 10 patients discontinued the treatment due of diarrhea in two weeks after the beginning of therapy with the use of diacerein. The results of the trial (in group 1) showed the significant reduction of joint pain on VAS (68,7±1,82 mm vs. 39,4±1,76 mm, p<0,001), WOMAC (126,4±2,77 vs 76,2±1,98 p<0,001), Lequesne (12,6±0,32 vs 9,1±0,33 p<0,001), HAQ (1,16±0,44 vs. 0,81±0,48 p<0,05), DAS28 (3,45±1,18 vs. 1,96±1,22, p<0,05). According to the findings of group 2, it was statistically significant reduce of all indicators. But the comparative analysis of the results in two groups revealed statistically significant differences between groups for most parameters for the benefit of group 1.
Conclusions The therapeutic approach with the use of inhibitor of interleukin-1 in the complex therapy of secondary OA of the knee in RA in comparison with traditional drug therapy is significantly more effective not only in the treatment of coexisting pathology (secondary OA), but and basic disease (RA).
Disclosure of Interest None Declared
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