Influence of comorbid pathology at the course of spondyloarthritis in patients receiving genetically engineered biological therapy


DOI: https://dx.doi.org/10.18565/therapy.2023.1.29-36

Samigullina R.R., Vasilenko E.A., Mazurov V.I.

1) I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 2) Saint Petersburg State University
Abstract. There are no clear data in scientific literature concerning the influence of comorbid pathology at the activity of spondyloarthritis (SpA) in patients receiving genetically engineered biological therapy.
The aim of the study is to assess the frequency of comorbid diseases in case of SpA and to study the correlation between SpA activity and the pathology of the cardiovascular system.
Material and methods. Publication presents data from the Center for therapy by genetically engineered biological preparations (GIBP) of I.I. Mechnikov North-Western State Medical University. The analysis included 146 patients who suffer from diseases of SpA group (according to ASAS criteria from 2009) and receive therapy with GEBD – TNF-α blockers. BASDAI and ASDASCRP indexes were used to estimate the activity of disease. From laboratory methods for assessing the activity of SpA, a highly sensitive method (mg/l) for CRP determination was used. Cardiovascular risk was assessed by means of the SCORE index with correction factor for patients with rheumatic diseases use.
Results. 85,6% of the examined SpA patients had at least one comorbidity. BASDAI and ASDASCRP activity indexes, as well as the BASFI functional index, were higher in the group of SpA patients with comorbid pathology, including cardiovascular system damage (various forms of coronary artery disease, hypertension), at the time of involving in the study.
Conclusion. A correlation between the incidence of comorbid pathology of the cardiovascular system and a high degree of SpA activity was found. The presented study demonstrates a more expressed disease activity in patients with SpA and the presence of comorbidity at the time of involving in the study, as well as a more significant decrease in their disease activity according to ASDASCRP and BASDAI comparatively with patients without comorbidities, which probably could occur due to the limited possibility of using NSAIDs in the group of patients with SpA and aggravated comorbid background.
Keywords: tumor-alpha necrosis factor inhibitors, spondyloarthritis activity indexes, spondyloarthritis, genetically engineered biological agents, comorbidity
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About the Autors

Ruzana R. Samigullina, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: dr.samigullina@yandex.ru. ORCID: https://orcid.org/0000-0002-6341-3334
Elizaveta A. Vasilenko, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, rheumatologist at the Clinic of High Medical Technologies named after N.I. Pirogov of Saint Petersburg State University. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: md.vasilenkoea@gmail.com. ORCID: https://orcid.org/0000-0003-2153-5429
Vadim I. Mazurov, MD, professor, academician of RAS, Chief scientific consultant, director of the Research Institute of Rheumatology and head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, head of the Center for autoimmune diseases of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Honored Worker of Science of the Russian Federation. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: maz.nwgmu@yandex.ru. ORCID: https://orcid.org/0000-0002-0797-2051


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