The effectiveness of combined pulse therapy in patients with rheumatoid arthritis

Abstract

Objective. To study the efficacy of the tolerance of combined regimens of the therapy with high doses of methylprednisolone and methotrexate of the patients with rheumatoid arthritis (RA).
 Materials and methods. The study included 85 patients with RA who underwent inpatient treatment in the Rheumatologic Department of the Clinical Hospital of Dushanbe city for the period 2018-2019. From them, women – 83.2 %, men – 26.8 %; the average duration of the disease is 7.4 years. Extra-articular manifestations of RA were determined in 74.3 % of patients. Against the background of the standard therapy, a regimen of bolus pulse therapy (methylprednisolone 500-1000 mg and methotrexate) was taken for 3 days, which has been followed for observation for a year. The effectiveness of the treatment was assessed according to the American College of Rheumatology (ACR) 20/50/70 criteria. The number of the swollen joints and painful joints (NPV), ESR, C-reactive protein level, and the overall disease activity were determined.
 Results and discussion. After 1 month of therapy, significant positive dynamics were recorded in the all estimated parameters of the RA activity. There was a significant decrease in NPV, as well as the intensity of pain according to the visual analogue scale. During 3 months of observation, 78 % of the observed patients showed improvement and only 11 % of patients had side effects and have not been required of the discontinuation of the treatment.
 Conclusions. The combined pulse therapy of methylprednisolone and methotrexate was an effective and well-tolerated for systemic manifestations of RA and contributed to a significant decrease in RA activity in the shortest time.