output The paper describes current ideas on the pathogenesis and treatment of nephrolithiasis, virtually a constant attendant of gout. The prevalence of nephrolithiasis is reported to be increasing worldwide. Among all cases of nephrolithiasis, the frequency of uric acid nephrolithiasis ranges from 5 to 40%; that of nephrolithiasis in gout is, according to the data by different authors, 7 to 10%. Hyperuricosuria, low urine volume, and low urine pH are considered to be classical risk factors for uric acid nephrolithiasis. Uric acid nephrolithiasis, including that in gout, even if asymptomatic, is noted to require active therapy. The paper presents the basic principles of treatment for uric acid nephrolithiasis: to normalize urine pH; to eliminate or neutralize the sequels of hyperuricosuria, to correct comorbidities, and to increase urine.

The paper presents the results of a trial of the efficacy and safety of the nonsteroidal anti-inflammatory drug Amelotex® (meloxicam) used to prevent episodes of arthritis in patients with gout during initiation of allopurinol therapy. The study has demonstrated that one-month therapy with Amelotex® can minimize the risk of arthritis exacerbations when allopurinol is used. Amelotex® shows a good tolerability and causes the low rates of side effects

Objective: to study the side effect profile of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatic diseases (RD). Subjects and methods. The study enrolled 373 patients (301 women and 72 men) with RD, the mean age of whom was 58.9±1.3 years; the duration of the disease was 6.1±0.7 years. This study was cross-sectional and randomized, by applying a questionnaire for the estimation of the NSAID side effect profile, developed at the Research Institute of Rheumatology, Russian Academy of Medical Sciences. Results and discussion. NSAIDs are an effective agent for the symptomatic treatment of pain and inflammation in most RDs. More than 50% of the patients with RD reported unpleasant sensations in the digestive system. Dyspepsia was present in the absolute majority of RD patients (77.7% of the patients with rheumatoid arthritis; 100% of those with ankylosing spondylitis; 47.8% of those with osteoarthosis) who had taken for more than a year

When nonsteroidal anti-inflammatory drugs (NSAIDs) are used, great attention is paid to their safety now. NSAIDs are primarily evaluated for their effects on the gastrointestinal mucosa, also assess the risk from NSAIDs on liver function. The retrospective analysis of 179 case histories of patients with rheumatoid arthritis, made at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, has revealed no hepatotoxic reactions in the treatment with nise alone and in combination with methotrexate or leflunomide, which are known to be hepatotoxic. There was not more than a 2-fold increase in the level of hepatic enzymes in 7.8 and 10.2% of patients receiving nise and diclofenac, respectively.

To join the efforts of rheumatologists and neurologists to study the clinical features of systemic rheumatic diseases (RD) contributed to the development of an interdisciplinary area that can be denoted as neurorheumatology. Nervous system lesion in RD is manifested by diverse symptoms and syndromes of the central and peripheral nervous system, which requires the correct evaluation of neurological abnormalities and adequate therapy.

The paper describes the pathomorphological aspects of ankylosing spondylitis (AS) and the value of nonsteroidal anti-inflammatory drugs in its therapy. Clinical trials demonstrate the high efficacy of aceclofenac (aertal) in AS.

The gastroprotective properties of tizanidine, a centrally acting myorelaxant, are discussed. It is noted that there is no strong evidence suggesting the ability of tizanidine to reduce the risk of serious gastrointestinal complications arising from with the use of nonsteroidal anti-inflammatory drugs and to decrease their need (average daily dose). It is stated that in inflammatory rheumatic diseases, myorelaxants (including tizanidine) are likely to be useful as a component of symptomatic therapy in a number of cases.

A great role in the pathogenesis of osteoarthrosis has been recently assigned to immune impairments, particularly to the involvement of proinflammatory cytokines (interleukin 1 (IL-1), tumor necrosis factor-α (TNF-α)) that activate catabolic processes not only in cartilage tissue, but also in the subchodral bone and other articular structures. Non-steroidal anti-inflammatory drugs, symptomatic slow-acting agents (chondroitin and glucosamine sulfate), as well as diacerein that blocks IL-1 directly and TNF-α indirectly, reduce the activity of cytokines to some extent.

The paper presents a classification of adverse drug reactions and their characteristics. Bisphophonates (BP) that are have been prescribed for more than 30 years to prevent and treat all forms of osteoporosis (OP) and recognized as first-line drugs for its treatment are used as an example to see the history of investigating rare and unexpected adverse reactions. The direct correlation between the rare adverse reactions of Ps and their use remains to be proven today. The proposal to reduce the prescriptions of BPs is unfounded. The evidence for the efficacy and safety of BPs in OP has been obtained and confirmed by multiple trials and many years X real practice. Alendronate (fosavance) is the most studied BP now.