EFFECT OF DISEASE-MODIFYING ANTIRHEUMATIC DRUGS ON THE VALUES OF APOLIPOPROTEIN A-1 AND ACUTE PHASE REACTANTS IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS

Broj: 2, 2016 Rubrika: Stručni rad Autori: Husni Ismaili, Suada Mulić-Bačić, Necmedin Karemani, Nikola Orovčanec

U ovom opservacijskom radu istražili smo utjecaj antireumatskih lijekova koji mijenjaju tijek bolesti (BMARL) na: aktivnost bolesti, vrijednosti reaktanata akutne faze i apolipoproteina A-1 (Apo A-1) u bolesnika s aktivnim reumatoidnim artritisom (RA). Osamdeset pacijenata s aktivnim i novootkrivenim RA, u skladu s revidiranim klasi fi kacijskim kriterijima Američkoga reumatološkog udruženja (ARA) iz 1987. godine, liječeno je lijekovima koji mijenjaju tijek upalne reumatske bolesti – BMARL-ima, u skladu sa standardnim protokolom liječenja u svakodnevnoj praksi. Nakon 6 i 12 mjeseci liječenja pacijenti su postigli značajno smanjenje vrijednosti DAS28 (disease activity score), CRP-a (C-reaktivni protein) i SE (sedimentacija eritrocita). S druge strane, razine Apo A-1, koje su na početku bile niske, značajno su se povisile. Zaključno, primjena BMARL-a u bolesnika s RA smanjila je aktivnost bolesti i upalu, ali je imala pozitivne učinke u smislu povišenja razine ateroprotektivnog Apo A-1, što može sniziti kardiovaskularne rizike.

In this observational study we examined the impact of disease-modifying antirheumatic drugs (DMARDS) on the disease activity as well as the values of acute phase reactants and the apolipoprotein A1 (Apo A1) in patients with active rheumatoid arthritis (RA). Eighty patients with active RA and newly discovered RA patients who meet the American Rheumatology Association (ARA) 1987 revised criteria were treated with disease modifying anti-rheumatic drugs – DMARDs according to the standard protocol of everyday clinical practice. At 6 and 12 months of treatment the patients
achieved a signifi cant decrease in the disease activity score 28 (DAS28), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values. On the other hand, the levels of Apo A-1, which were low at baseline, were signifi – cantly higher. In conclusion, the use of DMARDs in patients with RA reduced disease activity and infl ammation, but also had a benefi cial eff ect in increasing the levels of atheroprotective Apo A-1 lipoprotein, which can reduce CV risks in these patients.

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