Clinical indices and laboratory markers for evaluating the immune-mediated inflammation in rheumatoid arthritis: the impact of COVID-19

Patient-Oriented Medicine and Pharmacy, Journal Year: 2025, Volume and Issue: 3(1), P. 49 - 58

Published: March 25, 2025

Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease of unknown etiology that represents a considerable burden for both the patient and healthcare system. The degree to which inflammation being controlled determines prognosis; therefore, achieving remission or low activity paramount importance medical practitioners. effectiveness currently employed treatment regimen specific determined by indices change in their values during treatment. commonly used RA are result painstaking search optimal set clinical, laboratory instrumental parameters reflecting underlying pathogenesis spanning half century. Routine tests not included these can nevertheless provide additional valuable information regarding disease. new coronavirus infection, COVID-19, has similar pathogenetic mechanisms with immunoinflammatory rheumatic diseases, its clinical consequences form postcovid-19 syndrome, make it difficult assess using existing indices, raise question need take them into account when assessing choosing tactics RA.

Language: Английский

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Dynamics of specific immune response and autoantibodies against the background of vaccination with the Gam-COVID-Vac in healthy young individuals

Patient-Oriented Medicine and Pharmacy, Journal Year: 2025, Volume and Issue: 3(1), P. 64 - 76

Published: March 26, 2025

Relevance . The Coronavirus 2019 (COVID-19) pandemic has affected all countries of the world and renewed attention to timely prevention viral infections through specific immunization general population. However, some issues related safety vaccine administration production autoantibodies after remain unclear. Objective. To evaluate dynamics formation a immune response SARS-CoV-2 virus, autoantibody interrelationships between them during vaccination with Gam-COVID-Vac (Sputnik V) in healthy young adults. Material methods retrospective study included 45 practically students who were fully vaccinated two components at university medical center made 3 follow-up visits center. There 32 females (71.0%) 13 males (29.0%) aged 19 28 years, median age 23.00 [22.00;24.00] years. All trainees analyzed for IgG IgM antibodies serum by enzyme-linked immunosorbent assay (ELISA) using SARS-CoV-2-IgG-IgG-IFA-BEST SARS-CoV-2-IgM-IFA-BEST test systems, as well double-helix deoxyribonucleic acid (anti-dsDNA) kits (Vecto-dsDNA-IgG) Vector-Best JSC (Russia). concentration cardiolipin (IgM aCL, aCL) ELISA method (kits ORGenTec Diagnostika, Germany) was investigated three times 29 patients. Statistical processing results performed generally accepted parametric nonparametric analysis. Results. In examined individuals before Gam-COVID-Vac, levels low within reference values. After first component vaccine, level increased significantly compared period (KP: 0.28 [0.17;1.25] u.u. 0.07 [0.04;0.09] u.u., respectively, p <0.001). It remained high, baseline, stage 2 0.13 [0.07;0.37] <0.001), but underwent significant decrease second component, data 1 (p <0.01). vaccination, KP exceeded values 1.1 cfu 14 (31.11%) individuals, decreased 11.11% stage. baseline period, there dramatic increase both (KP:10.24 [6.78;12.44] 0.06 [0.05;0.11] <0.001) occurrence their high detection rate greater than u.u.) 91.11%, it reached 100.0%. higher found men women (KP 12.44 [10.24;15.78] 9.75 [4.50;11.95] women, aCL (1.41 [1.02;1.62] GPL U/mL 1.00 [0.87;1.32] U/mL, <0.05) trend toward anti-dsDNA concentrations >0.05) those opposite sex. not different >0.05). step, almost differences initial one (p=0.05). increased, reaching second-stage (1.37 [1.02;1.51] [0.81;1.40] <0.05). Only detected titer or drug. any case. Conclusions. age, antiviral is effectively formed when Gam-COVID Vac. more pronounced especially associated certain types characteristic immunoinflammatory rheumatic diseases. cases induction synthesis, transient.

Language: Английский

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Pharmacotherapy of autoimmune rheumatic diseases – from monoclonal antibodies to CAR T cells: 20 years later

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(3), P. 262 - 279

Published: June 26, 2024

Autoimmunity is a pathological process associated with violation of immunological tolerance to normal structural components the body (autoantigens), predominance active (adaptive) immunity and manifested by hyperproduction autoantibodies. Systemic autoimmune rheumatic diseases (SARDs) are among most common severe nosological forms this pathology autoimmunity. Problems pharmacotherapy SARDs subject intensive research. At beginning 21st century, more than 20 biologic agents were developed for treatment rheumatoid arthritis – monoclonal antibodies (mAbs) recombinant proteins that control inflammation overproduction “pro-inflammatory” cytokines, use which has dramatically improved results pharmacotherapy. However, much less research been devoted studying possibilities aimed at selective suppression “autoimmune” component pathogenesis SADRs uncontrolled activation B cells restoration autoantigens. In spectrum drugs whose mechanism action cells, leading place occupied rituximab (RTM). It noteworthy years ago (2004), group researchers led prof. J.C. Edwards first demonstrated effectiveness RTM in patients RA, was soon successfully repositioned treat wide range SARDs. A major achievement CAR (сhimeric antigen receptor) T cell therapy, refractory hematological tumors. The main CART-cells genetically engineered T-cell receptor recognizes target without participation histocompatibility complex. Although limited, extremely impressive data regarding high remission rates have obtained adapting CD19 CART-cell therapy systemic lupus erythematosus (SLE) other standard immunosuppressive medications. article discusses SLE prospects further

Language: Английский

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Results of a 24-week open-label, non-interventional study on the efficacy and safety of olokizumab therapy in patients with rheumatoid arthritis after switching from anti-B-cell therapy during the SARS-CoV-2 pandemic

Modern Rheumatology Journal, Journal Year: 2024, Volume and Issue: 18(3), P. 25 - 31

Published: June 14, 2024

In the context of new coronavirus infection (NCI) COVID-19 pandemic, rheumatological community is facing challenges in treatment immune-inflammatory rheumatic diseases (IIRDs). It has been shown that patients have an increased risk infections and a severe course NCI IIRD therapy also influences disease outcomes. particular, use anti-B-cell medication rituximab (RTM) associated with higher mortality. The pandemic highlighted need to find alternative safe options for these patients. This work continuation 12-week study on efficacy safety olok-izumab (OKZ) rheumatoid arthritis (RA) after switching from during SARS-CoV-2 pandemic. Objective: evaluate OKZ (Artlegia®; solution subcutaneous administration, 160 mg/ml – 0.4 ml) RA real-life clinical practice RTM Material methods. included 19 confirmed diagnosis who had received at dose 500–1000 mg twice every 14 days least 6 months ago. As activity increased, was replaced while synthetic disease-modifying anti-rheumatic drugs (DMARDs) continued. At weeks 0, 4, 8, 12 24 biologic DMARD, number tender (TJN) swollen (SJN) joints out 28, pain intensity visual analogue scale, ESR, CRP level, indices CDAI, DAS28-ESR, DAS28-CRP, HAQ index profile were assessed each visit. Results discussion. After there statistically significant decrease mean TJN (from 10 6.0, 3.0, 5.0 4.0, respectively; p < 0.05) SJN 7.0 3.0 by week 4 2.0 24; 0.05). same time, ESR values observed: median decreased 18 0.6 mg/l 0.5 (p 0.05), 30 5 mm/h period levels normalized regardless baseline values. All showed positive dynamic compared onwards assessment period. 24, DAS28-ESR 5.50 3.57; 3.30; 3.08 3.01 0.05); DAS28-CRP 5.30 3.46; 3.23; 3.26 3.12 CDAI 27.0 17.0; 12.0; 15.0 12.0 respectively. th observation. A improvement functional status observed maintained until 24. 1.62 1.50 8 1.12 Conclusion. non-medical switch effective safe.

Language: Английский

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Chronic neuroborreliosis and post-COVID syndrome: a clinical case

Patient-Oriented Medicine and Pharmacy, Journal Year: 2024, Volume and Issue: 2(3), P. 37 - 49

Published: Nov. 1, 2024

Lyme borreliosis is a natural focal, vector-borne disease caused by Borrelia burgdorferi sensu lato. The transmission of ixodes ticks characterized staged course with damage to various organs and systems. This an urgent problem in medicine because the peculiarities its clinical course, including late period. Not infrequently, due lack vigilance physicians polymorphism presentation disease, runs under masks other diagnoses. In Covid-19, new coronavirus SARS-CoV-2, both acute period later develop systemic manifestations central peripheral nervous systems musculoskeletal system. These features are particularly characteristic post-Covid-19 syndrome. A case chronic neuroborreliosis post-COVID-19 syndrome lesions muscular presented.

Language: Английский

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Efficacy, Immunogenicity, and Safety of the Combined Vector Vaccine Gam-COVID-Vac in Patients with Rheumatic Diseases

Antibiot Khimioter = Antibiotics and Chemotherapy, Journal Year: 2024, Volume and Issue: 69(7-8), P. 44 - 52

Published: Nov. 21, 2024

The aim of the study is to assess efficacy, immunogenicity, and safety combined vector vaccine Gam-COVID-Vac determine risk factors for development adverse events (AEs) in patients with rheumatic diseases (RD). Patients methods . present consisted a retrospective prospective parts, which included 295 42 RD, as well 113 57 healthy controls, respectively. Information about efficacy was obtained from 291 RD 146 assessed by incidence PCR-confirmed COVID-19 cases 31 365 days after vaccination. concentration antibodies SARS-CoV-2 enzyme immunoassay cohort at 1, 3, 6, 12 months administration second component vaccine. Safety studied all participants based on AEs exacerbation underlying RD. Results. After vaccination, 29 (9.97%) were recorded 27 them mild, 2 required hospitalization, ended recovery. Treatment rituximab before vaccination increased developing 2.3 times. A sig-nificant increase antibody titers observed full immunization (P<0.006 points). absent 40.72% 24.71% P<0.001. Exacerbations registered (0.6%) cases. local systemic (depending administered component) women, under age 60 year, duration less than 10 years, methotrexate therapy (P<0.016 cases). Conclusions According data obtained, use characterized good sufficient safety.

Language: Английский

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Colchicine: Repositioning an “ancient” medicine in the 21st century

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(5), P. 445 - 464

Published: Oct. 31, 2024

The main indications for colchicine treatment until recently were gout, pericarditis, familial Mediterranean fever and some other auto-inflammatory diseases. expansion of (repositioning) the use in direction prevention cardiovascular complications should be considered as one major events medicine XXI century. Deciphering role inflammation most important mechanism development atherosclerosis has created prerequisites concept anti-inflammatory therapy atherosclerosis, which low-dose can take an place, complementing effects aspirin, statins antihypertensive therapy. analysis materials from randomized placebo-controlled studies indicates a decrease frequency patients with coronary heart disease (by 31%) who have suffered myocardial infarction 23%), well 33%), stroke, need revascularization mortality. low dose (0.5 mg/day) is approved by U.S. Food Drug Administration disease. It assumed that future will place pathology associated atherosclerotic vascular

Language: Английский

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