Оценка сравнительной эффективности и отдаленных результатов лечения больных ревматоидным артритом

Objective of the research: to assess the comparative efficiency and long-term results of treatment of rheumatic arthritis (RA). Materials and methods: 80 RA patients have been examined. Of those, 40 patients (Group I) were administered with NSAIDs: Diclofenac 150 mg (daily dose), GCS: Prednisone 10 mg (daily dose), group II — 40 patients received NSAIDs, GCS and DMARDs: Methotrexate 10 mg (weekly dose). Dynamics of RA activity was assessed by DAS28 score at the beginning of the treatment course, then after 10 days, 6 months and 12 months, respectively, taking into account the radiological stage of the disease. Results: a comparative study of the effectiveness of therapy in dynamics immediately after in-patient treatment showed a decrease of the DAS28 score: RA patients with X-ray stage 1 by 3,4% in group I (not treated with DMARDs) and 6,4% in the group II (treated with DMARDs), compared to their first day in the clinic; X-ray stage 2: group I — 4,2%, group II — 8,5%; X-ray stage 3: reduction in DAS28 index in both groups was approx 1,8%. After 6 months of treatment a decrease in DAS28 in patients with X-ray stage 1 amounted to 6,7% and 12,9%, X-ray stage 2 — 8,3% and 6,3%, X-Ray stage 3 — 1,8% and 6,8% for two groups, respectively. After 12 months of treatment a decrease in DAS28 in patients with X-ray stage 1 amounted to 10,0% and 22,5%, X-ray stage 2 — 12,5% and 14,9%, X-Ray stage 3 — 7,1% and 13,7% for both groups, respectively. Conclusions: our research of the DMARDs effect on DAS28 score includes basic manifestations of immune and inflammatory process clearly showed the target effect of DMARDs on the rheumatoid process in dynamics of observation within 12 months. A study of the effectiveness of therapy in patients with RA showed significant efficacy of DMARDS in combination therapy with an analysis of the efficiency based on DAS28 score until stable remission of the disease.