NEUROMETABOLIC STRATEGY OF PHARMACOTHERAPY FOR PATIENTS WITH SERONEGATIVE ARTHRITIS

Abstract

The results of numerous clinical and epidemiological studies suggest that there is a close link between psycho-emotional disorders and chronic pain, which is an integral part of rheumatic pathology, including inflammatory seronegative arthritis. Medical and social significance and urgency of the problem of ankylosing spondylitis and psoriatic arthritis is determined by the constant progression of the disease with further affection of vertebrae and large joints, long-term disability, morbidity at a young age. Therefore, the complex treatment of these patients should include adjuvant drugs (anxiolytics, antidepressants, vegetative correctors, muscle relaxants), which do not have a direct analgesic effect, but, in addition to reducing the severity of anxiety-depressive and psycho-vegetative disorders, they reduce the intensity of nociception. The search for improving the strategy of neurometabolic pharmacotherapy in patients with seronegative arthritis and psoriatic arthritis therefore is of great clinical and social relevance, taking into account the nature of the psychological response to the diseases. The study groups demonstrated a high frequency of inadequate socio-psychological response to the disease. In the groups of patients with seronegative arthritis, multidirectional maladaptive reactions were observed: in ankylosing spondylitis, a hypochondriac type of response dominates; in psoriatic arthritis, anxiety disorders with different response options are the most prevalent. At the end of the observation period in both groups there has been registered an improvement in almost all studied indicators of clinical and laboratory activity. The patients demonstrated a significant improvement in the psycho-emotional status that improves the quality of life of patients and contribute to the optimization of the treatment and rehabilitation measures.