The paper considers the problem of comorbidity of gout and metabolic syndrome. It gives the data of the authors' study that has revealed the high prevalence of metabolic syndrome in patients with primary chronic gout, as well as a substantially higher cardiovascular risk in patients with the concomitance of these diseases. A role of hyperuricemia as an independent cardiovascular risk factor is demonstrated

Objective: to estimate quality of life in adolescents with juvenile arthritis (JA) on the basis of an analysis of the results of SF-36 questionnaire interviews.
Subjects and methods. Two groups of patients including 85 adolescents with JA (Group 1) and 34 apparently healthy individuals of their age (Group 2; controls) were examined. There were 63% of females among the patients. Systemic, polyarticular, oligoarticular, and juvenile ankylosing spondylosis JA (JAS) were diagnosed in 16 (19%), 34 (40%), 24 (28%), and 11 (13%) patients, respectively. The examinees' mean age was 15.2±1.1 years (range 14-17 years); the mean disease duration was 6.1±4.6 years (range 1-15 years). The control group comprised 73% of females; the mean age was 15.2+1.1 years (range 14-17 years); the adolescents went to school, they had neither musculoskeletal diseases nor release from physical training classes. The SF-36 questionnaire validated for those older than 14 years was used. Results. In Group 1, physical functions, physical activity, body pain, general health condition, and social functions were significantly worse than those in the controls. At the same time, viability, mental health, and emotional activity proved to be (statistically insignificantly) better in Group 1 than in the controls. In Group 1, the boys had better values of functional functions, physical activity, viability, and mental development while the girls had better values of body pain, general health condition, social functions, and emotional activity. In the control group, all these parameters were lower in the girls than in the boys. In Group 1 boys, all the parameters were significantly worse than those in the healthy peers (controls). Group 1 girls with JA had worse physical functions, physical activity, and pain, but better general health and social functions than the controls. Differences were found in the groups of patients with different types of JA: the parameters were significantly worse in those with systemic and oligoarticular types and better in those with JAS. Conclusion. The application of the SF-36 questionnaire could reveal significantly reduced physical functions in the patients with JA as compared to their healthy peers. It is expedient to use this questionnaire for intergroup comparative studies if sufficient clinical material is available.

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 describes current approaches to treating uveitis in rheumatic diseases and theoretical backgrounds for using tumor necrosis factor-α (TNF-α) inhibitors. The data available in the literature suggest that anti-TNF-α therapy is highly effective in relieving and preventing uveitis attacks.

The paper gives data on the use of a combination of genetic engineering biological agents (GEBAs) and leflunomide in patients with rheumatoid arthritis (RA). In accordance with the international guidelines, the majority of GEBAs should be given in a combination with methotrexate (MTX), which increases the efficacy of a number of GEBAs (tumor necrosis factor-α inhibitors, rituximab) and affects tolerability (remikeid, humira). However, MTX cannot be always used in real practice. The data given in the paper on the efficiency and safety of the coadministration of leflunomide and a GEBA in patients with active RA, which are based on the results of randomized studies and national registers, including the Russian one, point to the compatibility of the results of treatment with this and GEBA-MTX combinations.

The paper describes the .specific features of the clinical presentation, diagnosis, and treatment of pain syndrome in the lumbosacral area.

Back pain is a generalized type of locomotor lesion that is caused by soft tissue pathology and degenerative changes in the vertebral column in most cases and by intervertebral disk herniation, spinal stenosis, compression fractures in osteoporosis, by injuries, congenital anomalies, vertebral displacement less frequently, as well as by infections, tumors, inflammatory processes in the vertebral column, and related pain. A number of rheumatic diseases, including seronegative spondylarthritis, Scheuermann-Mau' disease, Forestier's disease, osteoarthrosis, etc., are accompanied by back pain. The cause of back pain syndrome cannot be frequently identified. This abnormality is treated by nonsteroidal antiinflammatory drugs, among which aceclofenac (Aertal) has acquired a reputation as an agent having a good tolerability.

The paper gives information on the selective COX-2 inhibitor etoricoxib registered for use in many countries of the world. It gives a brief description of a few key trials of the efficacy and tolerability of etoricoxib in rheumatology

The paper deals with the problem of osteoporosis (OP) in patients with chronic somatic diseases. It gives the data available in the literature and the authors' findings on the prevalence of OP. Particular attention is paid on the pathogenetic aspects of a relationship between OP and cardiovascular diseases. The extraskeletal effects of vitamin Dз deficiency and the results of a 24-month follow-up of patients receiving various antiresorptive agents are described.

The mechanism of action of the third-generation bisphosphonate zoledronic acid (Aclasta) is described; the data of randomized clinical trials of its efficacy and tolerability are given. It is concluded that zoledronic acid intravenously administered once a year may be the drug of choice for increasing patients' adherence to therapy, particularly in polypharmacy that is common in the elderly and in cognitive disorders. In addition, the drug may be given to postmenopausal women once every 2 years for the prevention of osteoporosis.

Nonsteroidal anti-inflammatory drugs (NSAIDs), the long-term administration of which is associated with a risk for complications, gastrointestinal tract (GIT) ones in particular, are extensively used to treat chronic pain in the back and limbs. The paper reviews the data available in the literature on adverse reactions occurring with the use of NSAIDs, discusses the issues of pharmacoeconomics in the administration of various NSAIDs. The use of the selective cyclooxygenase-2 inhibitor meloxicam (Movalis) is noted to cause fewer GIT adverse reactions than that of standard NSAIDs, the cost of treatment for GIT complications reduces.