Abstract
The role of skeletal muscle in the pathophysiology of knee OA is poorly understood. To date, the majority of literature has focused on the association of muscle strength with OA symptoms, disease onset and progression. However, deficits or improvements in skeletal muscle strength do not fully explain the mechanisms behind outcome measures in knee OA, such as pain, function and structural disease. This review aims to summarize components of skeletal muscle, providing a holistic view of skeletal muscle mechanisms that includes muscle function, quality and composition and their interactions. Similarly, the role of skeletal muscle in the management of knee OA will be discussed.
Highlights
Несмотря на большие достижения в лечении ревматоидного артрита (РА), связанные с разработкой новых методов ранней диагностики, внедрением в клиническую практику широкого спектра инновационных лекарственных препаратов и особенно совершенствованием стратегии их применения, глюкокортикоиды (ГК) по-прежнему остаются важнейшим компонентом фармакотерапии этого заболевания в реальной клинической практике
Despite major advances in the management of rheumatoid arthritis (RA), whicare associated with the development of new methods for its early diagnosis, the clinical introduction of a wide range of innovative medications and the improvement of a strategy for their use, glucocorticoids (GC) still remain the most important component of pharmacotherapy for this disease in real clinical practice
This publication that is a continuation of a series of papers devoted to the discussion of the main points of the 2013 European League against Rheumatism (EULAR) guidelines for the treatment of early RA, deals with the place of GC
Summary
Новые рекомендации по лечению ревматоидного артрита (EULAR, 2013): место глюкокортикоидов. It is anticipated that the wider use of combined therapy with methotrexate and a GC in earlyRA will be able to improve its prognosis in at least some patients and to cause a substantial decrease in the burden of disease, by reducing the risk of disability and the needs for expensive biological agents and joint replacement All this confirms that it is relevant to include the proposition for using GC into the 2014 Guidelines for the management of rheumatoid arthritis of the AllRussian public organization “Association of Rheumatologists of Russia”. Что, согласно рекомендации 7, «В качестве компонента стратегии лечения в течение первых 6 мес болезни следует рассматривать применение низких доз ГК (в комбинации с одним или несколькими базисными противовоспалительными препаратами – БПВП)». Таблица 1 Эффективность комбинированной терапии МТ (и другими БПВП или ГИБП) и ГК при раннем РА
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