It is pointed out that there is weighty evidence that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in osteoarthrosis (OA) and ankylosing spondyloarthritis (AS) can achieve not only symptomatic improvement, but also slower progression of the underlying pathological process. This effect is confirmed not only theoretically, but also experimentally and clinically. The information given in the review may serve as a ground for more active use of NSAIDs when there are direct indications for their use. It is stated that it is reasonable to switch from the purely symptomatic use of these drugs (only when pain occurs) to the practice of regular intake in their constant daily dose if pain in the joints and/or spine is present for most time.

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 use of tumor necrosis factor-α (TNF-α) inhibitors that selectively block important components of the immunopathogenesis of rheumatoid arthritis (RA) is a highly effective and relatively safe treatment for rheumatoid inflammation and can be considered as a new area in the therapy of autoimmune diseases, the basis of which is T- and B-cell immunity suppression. At the same time, it is necessary to conduct prospective studies that will be able to more exactly define the implication of TNF-α in the development of cardiovascular catastrophes and its inhibition in the prevention of cardiovascular events in patients with RA.

The literature review deals with the clinical and laboratory manifestations of systemic lupus erythematosus (SLE). The data available in the literature and the authors’ experience suggest that it is difficult to verify the valid diagnosis of the disease, in its atypical variants in particular. The correct assessment of the clinical and laboratory manifestations of SLE in each patient, the detection of an exacerbation of the underlying disease and concomitant pathology, the evaluation of the efficiency of performed therapy, and a search for prognostic markers for an outcome are of great value.

Treatment options for giant cell arteritis (GCA) and its complications are considered. GCA is treatable with glucocorticoids (GC). The data available in the literature suggest that it is necessary to hospitalize GCA patients with acute vision loss or brain ischemia to administer intravenous megadose methylprednisolone and to control and prevent complications of GC therapy. It is expedient to use aspirin in these cases. The evidence for the use of methotrexate and other disease-modifying antirheumatic and genetically engineered drugs as GC-saving drugs is discussed.

Objective: to elucidate the awareness of osteoarthrosis - OA (the most common location and treatment methods) among primary care physicians. Subjects and methods. The questionnaire developed at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, was used to interview 1912 specialists (therapists, rheumatologists, neurologists, and surgeons) who made a primary outpatient reception in the local polyclinics of 25 Russian Federation’s cities with a population of more than 500,000. Results. In the opinion of the physicians of all specialties, knee joints turned out to be the most location of OA. In practice, the rheumatologists encountered knee, hip, and hand joint lesions in OA in 92, 42, and 38%, respectively. Analysis of therapeutic preferences has shown that virtually all the physicians prescribe nonsteroidal anti-inflammatory drugs and only two thirds do structure-modifying drugs (chondroprotectors) for OA patients. When treating OA, only the rheumatologists use slow-acting drugs in practically 100% of cases, by preferring chondroitin sulfate. The physicians of all specialties use topical glucocorticoid therapy extensively. The rheumatologists use this therapy most probably due to the fact that patients with severe polyarticular OA come to see them. Notwithstanding the fact that new guidelines for the treatment of OA were published in 2008, most physicians are oriented to the 1995 guidelines, frequently giving rise to therapeutic errors and wrong treatment.

The results of examination using the CHAQ are employed to analyze the degree of vital activity limitation in patients with different types of juvenile chronic arthritis. Whether it is advisable to use the questionnaire in young preschoolers is discussed.

The paper describes the pathological aspects of an inflammatory process in ankylosing spondyloarthritis (AS), the role of muscle spasm in maintaining the intensity of pain syndrome and stiffness, the need for the early diagnosis of AS, and the significance of the early use of nonster-oidal anti-inflammatory drugs in these patients. The results of clinical trials and the authorsX data demonstrate the high efficacy and good tolerance of nimesulide (nise) in AS.

The paper gives the results of randomized clinical trials and the use of meloxicam in real clinical practice in patients having risk factors for unfavorable gastrointestinal and cardiovascular events. It shows the advantages of meloxicam in safety and equal efficacy as compared with those of nonselective nonsteroidal anti-inflammatory drugs, and its high safety in causing gastrointestinal complications, which is highly competitive with that of celecoxib. Clinical and experimental findings suggesting that meloxicam has no negative effect on the cartilage are presented.

The insights into the pathogenesis of osteoarthrosis (OA) are being constantly expanded. A great role in the development of OA is assigned to immune disorders, particularly to proinflammatory cytokines (interleukin-1 — IL-1, tumor necrosis factor-α). Among the proinflammatory mediators, IL-1 is of the greatest value. Diacerein that is acetylated derivative of rein is used to inhibit the activity of IL-1 in OA. Nonsteroidal anti-inflammatory drugs, nimesulide in particular, reduce the activity of cytokines to some degree.

Objective: to make a pharmacoeconomic analysis of the use of oral (a 150-mg tablet once a month) and injectable (a solution for intravenous bolus injection of 3 mg in 3 ml once every 3 months) ibandronate in patients with postmenopausal osteoporosis (OP). Material and methods. The cost minimization method was used to calculate differences in the cost of using oral ibandronate, alendronate, and strontium ranelate in patients with postmenopausal OP for a year. The budgetary impact of administration of intravenous bisphosphonates (ibandronate and zoledronic acid) was analyzed in patients with OP in a hospital context. A model calculator based on the Microsoft Excel software was applied to estimate how the expenditures of a health care facility were changing when different shares of drugs (ibandronate and zoledronic acid) were used in purchase patterns. The cost of therapy with bisphosphonates (ibandronate and zoledronic acid), concomitant therapy (calcium and vitamin D), expendable materials, and therapy for adverse reactions (ARs) due to the use of bisphophonates was considered in terms of the incidence of these ARs. Results. Among the oral drugs, ibandronate is more economically sound than alendronate: the difference in annual treatment costs was 7090.02 and 7334.31 rubles per patient, respectively, in favor of ibandronate. The inpatient use of only intravenous ibandronate versus the real administration practice determined on the basis of the data of the Farmekspert Marketing Researches Center on purchases in the hospital segment (30% for ibandronate and 70% for zoledronic acid) considerably reduces the expenditures of a hospital, the saving will be 185416.06 rubles per year (if injections will be made in 20 patients). With 100% use of ibandronate, one can additionally provide 39 inpatients with bisphosphonate injections without additional expenditures.