Rapid Radiographic Improvement Research Articles

Возможности патогенетической терапии новой коронавирусной инфекции

Aim: to assess clinical efficacy of azoximer bromide in the complex inpatient treatment for COVID-19. Patients and Methods: the study included 20 patients aged 16–65 years with verified moderate novel coronavirus infection who received inpatient care. All patients were divided into two groups. Study group patients (n=10) received complex treatment that included azoximer bromide. Control group patients (n=10) received standard therapy only. The criterion of treatment efficacy was the improvement of major disease symptoms, radiographic manifestations, and pro-inflammatory laboratory tests. Results: azoximer bromide as a component of the treatment for novel coronavirus infection provides more rapid symptom relief (i.e., cough, sputum, fever, respiratory rate) compared to the standard therapy (p<0.05). azoximer bromide also provides more rapid radiographic improvement as demonstrated by helical computed tomography, i.e., by day 14, the percentage of lung parenchyma involved was 5% in the study group and 10–12% in the control group (p<0.05). In addition, the improvement of pro-inflammatory laboratory tests (i.e., normal WBC count, decrease in ESR) was revealed as well (p<0.05). Conclusion: azoximer bromide as a component of the complex treatment for novel coronavirus infection is associated with the clinical improvement that manifests with more rapid relief of inflammation and lung parenchyma involvement as compared with the standard therapy. No adverse reactions were reported. KEYWORDS: coronavirus infection, SARS-CoV2, COVID-19, pneumonia, immune correction, pathogenetically-oriented therapy, azoximer bromide. FOR CITATION: Mukhamadieva L.R., Mavzyutova G.A., Tyurina E.B., Kuzovkina O.Z. Pathogenetically-oriented therapy for novel coronavirus infection. Russian Medical Inquiry. 2020;4(4):192–198. DOI: 10.32364/2587-6821-2020-4-4-192-198.

Efficacy of golimumab for preventing large joint destruction in patients with rheumatoid arthritis as determined by the ARASHI score

Objectives: The objective of this study is to investigate the inhibitory effect of golimumab on large joint destruction in patients with rheumatoid arthritis.Methods: We recruited 45 patients with rheumatoid arthritis and evaluated the radiographic severity of large joint destruction using the assessment of rheumatoid arthritis by scoring of large joint destruction and healing in radiographic imaging (ARASHI) score. We evaluated 450 large joints including the elbow, shoulder, hip, knee, and ankle at baseline and 52 weeks after treatment with golimumab. Rapid radiographic progression (RRP) and rapid radiographic improvement (RRI) were calculated and the correlation between large joint destruction and clinical factors was analyzed.Results: The mean age of the study population was 61.29 ± 14.71 years old, and most patients (91.1%) were female. The mean disease duration was 12.6 ± 12.48 years. The cohort included patients in all clinical stages of disease as defined by the Steinbroker criteria (I:7, II:10, III:9, IV:19) as well as clinical classes 2 (n = 18), 3 (n = 26), and 4 (n = 1) and the mean disease activity score-CRP (DAS28-CRP) was 4.431 ± 1.044. Patients were treated with methotrexate (mean dose 6.44 ± 1.78 mg/week), prednisolone (PSL) (mean dose 1.078 ± 1.871 mg/d), and golimumab (44.4% of 100 mg). RRP was evident in 20% of the large joints treated with golimumab, and, therefore, golimumab was effective at inhibiting large joint destruction in 80% of joints. RRI was evident in 33.3% of large joints following golimumab treatment. We also observed that EULAR response criteria significantly correlated with the ARASHI change score at 52 weeks after treatment. The total ARASHI status score significantly correlated with the Sharp–van der Heijde score, but not with the delta total sharp score. Multiple regression analyses revealed that the total ARASHI change score was only correlated with EULAR response criteria significantly.Conclusions: Golimumab therapy was effective at inhibiting large joint destruction of RA patients who have good clinical response, including higher improvement of the shoulder and ankle joints than other large joints.

A Case of Worsening Deep Cerebral Venous Sinus Thrombosis Managed by Intrasinus Thrombolysis

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with severe consequences. Although we do not know the exact incidence and prevalence of CVST, it is an important diagnosis. Over the past decade, it has been diagnosed more frequently due to greater awareness and availability of noninvasive diagnostic techniques. Furthermore, routine diagnostic neuroimaging has been used to monitor the clinical progress of these patients, especially in deteriorating cases. In order to decrease morbidity and mortality, an understanding of CVST treatment options is important. Treatment of extensive intracranial venous sinus thrombosis with intrasinus infusion of recombinant tissue plasminogen activator (rt-PA) is relatively controversial as there are no clear guidelines in regards to appropriate therapeutic management. We report a case of successful intrasinus thrombolysis of deep cerebral sinus thrombosis (DCST) resulting in rapid radiographic improvement associated with complete clinical recovery.