Objective: to evaluate the efficacy and safety of etoricoxib (Arcoxia ®) in gouty patients with an acute arthritis attack in real clinical practice. Subjects and methods. Thirty patients (25 men and 5 women; mean age 52.4±13.5 years) with crystal-verified gout participated in the pilot open-label study of the patients with arthritis, including those who had taken other nonsteroidal anti-inflammatory drugs (NSAIDs) without any effect. All the patients received etoricoxib (Arcoxia ®) in a dose of 120 mg/day for 7 days and, if arthritis persisted, in a dose of 90 mg/day for 7 more days. The authors estimated an articular index, swelling and hyperemia indices, resting and movement pain by a visual analogue scale (VAS), therapy tolerance in the patient's opinion before and 7 days after therapy and, in the patients taking etoricoxib for 14 days, after 14 days of therapy. Biochemical and clinical blood tests were carried out at the first and subsequent visits. Results. Seven days after therapy, an arthritis attack was abolished in 24 of the 28 patients, following 14 days, arthritis persisted only in 1 patient, but the number of affected joints reduced from 8 to 2. Following 7 days, there was a reduction in the mean erythrocyte sedimentation rate from 37.2+10.2 (before etoricoxib intake) to 15.3±8.3 mm/h (p<0.001), VAS resting pain from 48.6±21.4 to 5.2±3.5 mm (p<0.001), swelling (p<0.001) and hyperemia (p< 0.001) indices, and articular index (p<0.001). In 2 patients with baseline uncontrolled arterial hypertension, the drug was discontinued because of elevated blood pressure; periorbital edema was noted in one case by the end of a therapy course. There were no increases in the serum levels of liver enzymes, in the concentrations of creatinine and urea, and in glomerular filtration rate. Conclusion. Etoricoxib (Arcoxia ®) is highly effective and safe when used in patients with acute gouty arthritis, including those who had not benefited from previous NSAID therapy and those with oligoand polyarthritis.

Objective: to evaluate the efficacy and safety of etoricoxib (Arcoxia ®) in gouty patients with an acute arthritis attack in real clinical practice. Subjects and methods. Thirty patients (25 men and 5 women; mean age 52.4±13.5 years) with crystal-verified gout participated in the pilot open-label study of the patients with arthritis, including those who had taken other nonsteroidal anti-inflammatory drugs (NSAIDs) without any effect. All the patients received etoricoxib (Arcoxia ®) in a dose of 120 mg/day for 7 days and, if arthritis persisted, in a dose of 90 mg/day for 7 more days. The authors estimated an articular index, swelling and hyperemia indices, resting and movement pain by a visual analogue scale (VAS), therapy tolerance in the patient's opinion before and 7 days after therapy and, in the patients taking etoricoxib for 14 days, after 14 days of therapy. Biochemical and clinical blood tests were carried out at the first and subsequent visits. Results. Seven days after therapy, an arthritis attack was abolished in 24 of the 28 patients, following 14 days, arthritis persisted only in 1 patient, but the number of affected joints reduced from 8 to 2. Following 7 days, there was a reduction in the mean erythrocyte sedimentation rate from 37.2+10.2 (before etoricoxib intake) to 15.3±8.3 mm/h (p<0.001), VAS resting pain from 48.6±21.4 to 5.2±3.5 mm (p<0.001), swelling (p<0.001) and hyperemia (p< 0.001) indices, and articular index (p<0.001). In 2 patients with baseline uncontrolled arterial hypertension, the drug was discontinued because of elevated blood pressure; periorbital edema was noted in one case by the end of a therapy course. There were no increases in the serum levels of liver enzymes, in the concentrations of creatinine and urea, and in glomerular filtration rate. Conclusion. Etoricoxib (Arcoxia ®) is highly effective and safe when used in patients with acute gouty arthritis, including those who had not benefited from previous NSAID therapy and those with oligoand polyarthritis.

The impact of a 4-week course of therapy with Uralyt-U (potassium-sodium hydrocitrate) on uric acid (UA) metabolic parameters was studied in patients with gout and nephrolithiasis. Elevated daily urinary excretion of UA was found to be directly correlated with its lower serum level after 4-week therapy with Uralyt-U (p < 0.05), resulting in improvement and normalization of UA metabolism. Uralyt-U therapy is safe and causes no worsening of the parameters of hepatic and renal function and electrolyte exchange.

Cardiovascular diseases (CVD) caused by vascular atherosclerotic lesion are the leading cause of death in gout patients. Analysis of the data available in the literature has indicated that monitoring blood pressure and target organ damage thoroughly serves as the basis for the prevention of CVD and cardiovascular catastrophes in patients with gout.

Cardiovascular diseases (CVD) caused by vascular atherosclerotic lesion are the leading cause of death in gout patients. Analysis of the data available in the literature has indicated that monitoring blood pressure and target organ damage thoroughly serves as the basis for the prevention of CVD and cardiovascular catastrophes in patients with gout.

The paper presents the results of a trial of the efficacy and safety of the nonsteroidal anti-inflammatory drug amelotex® (meloxicam) in patients with gonarthrosis. One-month meloxicam therapy is shown to have a good analgesic effect and tolerability and to improve quality of life in the patients.

The paper presents the currently available data on a cardiovascular risk in patients with rheumatic disease when taking meloxicam, one of the widely used nonsteroidal anti-inflammatory drugs.

The paper describes the basic principles of diagnosis of microcrystalline arthritis by polarization microscopy. Emphasis is laid on the importanceof determination of the crystals of sodium monourate and calcium pyrophosphate for the diagnosis of microcrystalline arthritis and on the techniquesof polarization microscopy and puncture of joints.

The paper describes the basic principles of diagnosis of microcrystalline arthritis by polarization microscopy. Emphasis is laid on the importance of determination of the crystals of sodium monourate and calcium pyrophosphate for the diagnosis of microcrystalline arthritis and on the techniques of polarization microscopy and puncture of joints.

The paper deals with the clinical experience in using Remicade®, a tumor necrosis factor-a (TNF-а) inhibitor, in patients with chronic tophaceous gout resistant to therapy with glucocorticoids and nonsteroidal anti-inflammatory drugs. The agent is noted to have a good long-acting clinical effect in reducing the number of tender and swollen joints, as confirmed by the theoretical rationale for the use of anticytokine agents, TNF- а inhibitors in particular, in gouty patients.

The paper presents data on the prospects for clinical use of the nonsteroidal anti-inflammatory drug Amelotex® (meloxicam) in patients with osteoarthrosis. It also gives the results of a study showing a good efficacy and tolerability of Amelotex® in patients with gonarthrosis.

Objective: to study the efficacy and tolerability of infliximab (Remicade) in the major syndromes of psoriatic arthritis (PA). Subjects and methods. The study was based on Remicade therapy in 22 patients with severe and moderate PA with polyarthritic, osteolytic and spondyloarthritic types of the joint syndrome, generalized psoriasis vulgar and erythrodermata, and pustular psoriasis. Inflammatory activity was determined by DAS 4 and the efficiency of therapy was evaluated by the ACR and EULAR criteria. The severity of psoriasis was judged from the PASI index. Inefficiency or intolerability of essential anti-inflammatory drugs (EAIDs) was observed in all the patients. Therapy with Remicade in combination with methotrexate was performed in 7 patients; the other patients took Remicade without EAIDs. The drug was intravenously injected in a dose of 5 mg/kg by the generally accepted scheme. The efficacy of the first 5 Remicade infusions was evaluated. Results. Just after the first infliximab infusion, there was a significant reduction in the intensity of joint pains and in the duration of morning stiffness, as well as in the number of tender and inflamed joints. The improvement was associated with the duration of treatment. Remicade therapy resulted in diminished inflammatory activity. Before treatment the high activity of PA, estimated from the DAS 4 index, was determined in 71,4% of the patients; and after the second infusion it was seen only in 5%. After three infusions or more, there were a larger number of patients with 70ACR scores, i.e. those with a very good effect of therapy; and after 5 infusions; the number of such patients was as high as 91%. According with the EULAR criteria, a good therapeutic effect was observed in 89% of cases. The course of psoriasis was less pronounced. PA remission occurred in every 6 and every 3 patients after the second and fifth infusions, respectively. Conclusion. Remicade is the most effective drug among the available anti-inflammatory ones for the treatment of PA. It strongly affects the major syndromes of this disease.

Objective - to evaluate the effect of Blemaren on uric acid (UA) metabolic parameters in gout patients with nephrolithiasis and the possibilities of its use in combined therapy for gout. Patients and methods. The study included 30 patients (26 males and 4 females) aged 50 years (range 36 to 61 years) who had crystal-verified gout in the presence of nephrolithiasis. All the patients took Blemaren in an initial dose of 3 g/day; the dose of the drug was adjusted depending on the urine acidity (the pH value was maintained at 6,2-6,8). Physical and laboratory studies were conducted before and a month after the drug's administration. The treatment performed before the patients ' inclusion into the study remained the same for at least 2 months. Fifteen patients received allopurinol in a dose of 100-200 mg/day. Results. After completion of a course of Blemaren therapy, there was an 8% reduction in the mean serum UA levels, which correlated with an increase in its daily excretion (by an average of 20%). The highest increase in UA excretion was observed in 20 patients with baseline hypoex-cretion (<700 mg/day): from 226,3 (range 201,6-436,8) to 635,0 (range 272,2-705,6) mg/day (p = 0,01). UA excretion substantially unchanged in patients with normal uricosuria (>700 mg/day). Side effects that could cause the agent to be discontinued were absent. Conclusion. The Blemaren citrate formula used in gout patients with nephrolithiasis causes a significant increase in the renal excretion of UA (p = 0,01), normalizes its metabolic parameters, and shows a high safety, without worsening hepatic and renal functions and electrolyte metabolism.