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AB0410 Use of disease-modifying treatment (dmard) in patients with rheumatoid arthritis: clinical aspects
  1. N. Nikitina,
  2. I. Afanaciev,
  3. A. Rebrov
  1. Saratov State Medical University, Saratov, Russian Federation


Background Rheumatoid arthritis (RA) is one of the most common occurrence diseases with a high frequency (about 1%) in the general population. More the 4500 patients with rheumatoid arthritis registered in Saratov region in the Russia. Rheumatoid arthritis becomes an important cause of the working capacity persistent losses and patients quality of life diminishing. Specialties of this pathology are very expensive treatment, laboratory examinations and a growth of cardiovascular disorders risk. Disease-modifying therapy is the main part of combined treatment which slows joints erosive failure’s development and greatly reduces a progression of the autoimmune inflammation.

The aim of this work was to analyze the use of different medicaments of disease-modifying therapy in patients with rheumatoid arthritis. To evaluate the frequency of changes the therapy and variation the DMARD combination.

Objectives The study includes 100 patients (83 women and 17 men) from 18 to 76 years old with RA duration from 6 month to 50 years continually observed in the rheumatology department of the Saratov Region Clinical hospital.

Methods Analisys disease activity during period investigatore.

Results 96 (96%) patients received disease-modifying medicaments. Assortments of the time from the diagnosis identification to beginning of the treatment were: smaller than 6 month - 34 patients (35,42%), from 1 to 2 years – 22 (22,92%), 2-10 years – 21 (22,88%), 11-20 years – 10 (10,42%), 21-30 years – 5 (5,21%), more than 30 years – 3 (3,125%). Methotrexate has been used as an initial medicine for 77 patients (80, 2%), leflunomide – for 3 patients (3,1%), sulfasalazine – 2 (2,08%), chloroquine – 8 (9,19%), hydroxychloroquine – 5 (5,75%). 80 patients received methotrexate continually or exchanged other disease-modifying agents to methotrexate. These patients used methotrexate for a long time (from 2 to 14 years). The same medicines were administrated like the second-line choice: sulfasalazine – for 32 patients (33,3%), leflunomide - 10 (10,42%), azathioprine - 1 (1,04%).

The monotherapy with leflunomide or methotrexate has been transformed into the combined schemes of treatment to 25 patients (28,74%) with unequal therapeutic efficiency. The following variants of the complex treatment have been occurred: methotrexate with sulfasalazine – to 13 (52%) patients, methotrexate + chloroquine – 1 (4%), methotrexate + leflunomide – 3 (12%), methotrexate + ciclosporin – 2 (8%), sulfasalazine + leflunomide – 1 (4%), methotrexate + leflunomide + azathioprine – to 1 (4%) patient/

Conclusions Methotrexate is main disease-modifying agent in patients with rheumatoid arthritis; sulfasalazine is medication of the second-line. Most patients (59,7%) begin receive DMARD therapy in the early stage (recent-onset) rheumatoid arthritis in real clinical practice. 28,7% patients need of complex disease-modifying therapy. Methotrexate and sulfasalazine combination more frequently used in the complex therapy in patients with non-effectives monotherapy DMARD.

Disclosure of Interest None Declared

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