Abstract
Objective. To assess efficacy of De-Nol in NSAID-induced gastropathies. Material and Methods. 45 pts with rheumatic diseases taking NSAID with gastric and/or duodenal ulcer up to 1 cm of size or multiple (>10) gastric erosions (MGE) confirmed with endoscopy were included. They were randomized to receive De-Nol 240 mg twice a day with amoxicillin 2 g/day and furosolidon 400 mg/day (subgroup la) or De-Nol 240 mg twice a day as monotherapy (subgroup lb). Group 2 patients were treated with ranitidin 150 mg twice a day. Demographic parameters, nosological structure, treatment of the main disease and gastrointestinal changes stmcture in these groups did not significantly differ. Elderly women with rheumatoid arthritis and gastric ulcer were prevalent. HP was revealed in 73,3% and 90% of pts. Dyspepsia and heartburn were present in 90% and 93,3% respectively. Therapy efficacy was assessed after 4 weeks. Preventive effect was assessed in 2 months after the successful treatment course. Preventive doses of the drugs were equivalent to ? of treatment doses. Results. 3 pts from group 1 and 1 pt from group 2 were lost to follow up. I pt from group I stopped De-Nol prematurely because of adverse event (diarrhea). Ulcer and erosion healing was achieved in 22 from 26 pts of group I (86.6%) and from 7 from 14 pts of group 2 (50%), p=0.036. After the course of therapy remained in in 4 pts of group 1 (15,4%) and 9 pts of group 2 (64,3%), p=0.003. 3 pts receiving De-Nol had adverse events (2 - diarrhea, 1 - wind). Antihelicobacter effect was assessed in 7 pts of subgroup la. Eradication was achieved only in 3. Antiulcer effect in subgroup la and lb did not differ (88,8% and 82,4% respectively, p=0,732. HP was present in 12 from 20 pts (60%) of subgroup lb. Antiulcer therapy was effective in 6 from 7 of HP-negative (85,7%) and in 8 from 10 of HP positive (80%) pts, p=0,S4l. Preventive effect was assessed in 15 pts of group I and 5 pts of group 2. Relapse frequency was 13,3% and 20% respectively. Conclusion. De-Nol is effective in NSAID-induced gastropathies and its effect does not depend on HP.
Highlights
Сложность лечения больных с патологией опорно-дви гательного аппарата заключается еще и в том, что это пре имущественно лица пожилого возраста, что само по себе является фактором риска развития непереносимости Нестероидные противовоспалительные препараты (НПВП) со стороны Ж К Т [7], сердечно-сосудистой системы
Противоязвен ная терапия была эффективна у 6 из 7 HP - негативных б-ых (85,7%) и у 8 из 10 из HP - по зитивных б-ых (80%), р = 0,841
D e-Nol is effective in NSAID-induced gastropathies and its effect does not depend on HP
Summary
To study efficacy and safety of Vitrum Osteomag (VO) in prophylaxis o f osteoporosis in pts with rheumatoid arthritis (RA) during 12 months. Как возраст, генетические особенности и особен ности питания, при этом заболевании на развитие ОП влияют: хроническое воспаление, снижение функциональ ной активности больных, негативное влияние на обмен костной ткани ряда лекарственных препаратов, в первую очередь глюкокортикоидов (ГК) [9]. Снижение МПК в различных участках скелета и увели чение риска переломов костей при РА наблюдается одина ково часто как у женщин, так и у мужчин [41, 64]. A. Verstraeten и J.D equeker, исследовав 104 женщин с РА в постменопаузе (больные были разделены на 2 группы - леченные ГК и не леченные ГК), обнаружили, что как переломы тел позвонков, так и переломы шейки бедра встречались достоверно чаще в группе больных, леченных ГК [76].
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