Effect on lung function of methotrexate and non-steroid anti-inflammatory drugs in children with juvenile rheumatoid arthritis

The pediatrician frequently encounters children and adolescents with musculoskeletal complaints that raise the possibility of rheumatic disease. The purposes of this article are: to review an approach to the evaluation of "joint" symptoms and to review the pharmacology, use, and adverse effects of nonsteroidal anti-inflammatory drugs. RHEUMATOLOGIC HISTORY Systematic collection of the historical details is fundamental in the evaluation of "joint" complaints (Table 1). Age and Sex The child's age and sex provide initial clues. For example, suspicion that a young girl (less than 5 years of age) with knee swelling might have monoarticular juvenile rheumatoid arthritis is heightened simply because of her age and sex. (At onset of their disease, almost 20% of all patients with juvenile rheumatoid arthritis are young girls with pauciarthritis, most commonly involving the knee.) Suspicion that an older boy (10 years of age or older) with axioskeletal complaints might have an enthesopathy syndrome is increased, in part, because of his age and sex. of the age and sex predilections of various rheumatic conditions is, therefore, helpful. Chief Complaint The chief complaint is often directive. For example, the complaint "his knees hurt every night" or "his legs hurt at night" is not characteristic of children who have juvenile rheumatoid arthritis or other well-defined inflammatory arthritides.

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Cost-effectiveness of Non-steroidal Anti-inflammatory Drugs Adjusting for Upper and Lower Gastrointestinal Toxicities in Rheumatoid Arthritis Patients

Journal of Rheumatic Diseases ◽

10.4078/jrd.2017.24.1.27 ◽

2017 ◽

Vol 24 (1) ◽

pp. 27

Author(s):

Soo-Jin Chung ◽

Hye-Jin Park ◽

Min-Chan Park

Keyword(s):

Rheumatoid Arthritis ◽

Cost Effectiveness ◽

Inflammatory Drugs ◽

Anti Inflammatory

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Rheumatoid arthritis: influence of inflammation and anti-inflammatory therapy on cardiovascular risk factors

Medical Council ◽

10.21518/2079-701x-2020-11-32-44 ◽

2020 ◽

pp. 32-44

Author(s):

D. I. Trukhan ◽

D. S. Ivanova ◽

K. D. Belus

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factors ◽

Chronic Inflammation ◽

Pharmacological Intervention ◽

Increased Risk ◽

Inflammatory Drugs ◽

Anti Inflammatory

Rheumatoid arthritis is a frequent and one of the most severe immuno-inflammatory diseases in humans, which determines the great medical and socio-economic importance of this pathology. One of the priority problems of modern cardiac rheumatology is an increased risk of cardiovascular complications in rheumatoid arthritis. In patients with rheumatoid arthritis, traditional cardiovascular risk factors for cardiovascular diseases (metabolic syndrome, obesity, dyslipidemia, arterial hypertension, insulin resistance, diabetes mellitus, smoking and hypodynamia) and a genetic predisposition are expressed. Their specific features also have a certain effect: the “lipid paradox” and the “obesity paradox”. However, chronic inflammation as a key factor in the development of progression of atherosclerosis and endothelial dysfunction plays a leading role in morbidity and mortality from cardiovascular diseases in rheumatoid arthritis. This review discusses the effect of chronic inflammation and its mediators on traditional cardiovascular risk factors and its independent significance in the development of CVD. Drug therapy (non-steroidal anti-inflammatory drugs, glucocorticosteroids, basic anti-inflammatory drugs, genetically engineered biological drugs) of the underlying disease also has a definite effect on cardiovascular risk factors in patients with rheumatoid arthritis. A review of studies on this problem suggests a positive effect of pharmacological intervention in rheumatoid arthritis on cardiovascular risk factors, their reduction to a level comparable to the populations of patients not suffering from rheumatoid arthritis. The interaction of rheumatologists, cardiologists and first-contact doctors (therapist and general practitioner) in studying the mechanisms of the development of atherosclerosis in patients with rheumatoid arthritis will allow in real clinical practice to develop adequate methods for the timely diagnosis and prevention of cardiovascular diseases in patients with rheumatoid arthritis.

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