The Evaluation of Different Treatment Regimens in Patients with Psoriatic Arthritis
Summary. Summary. The aim. To evaluate the efficacy and safety of the efferent methods of therapy (plasmapheresis) in patients with psoriatic arthritis. Methods. In 24-week study we observed 60 patients, which were divided to two groups. In 1st group patients received methotrexate for 10 mg weekly, followed by increasing of 2.5 mg every two weeks to 20 mg per week, folic acid 5 mg weekly, in 48 hours after taking methotrexate. In the 2nd group patients received 5 membrane plasmapheresis cycles every other day in addition to standart treatment. All patients received NSAIDs for 14 days: natrium diclofenak 150 mg/day (75 mg twice daily), and nimesulide for 200 mg daily. There were not additional corticosteroids and immunosuppressive treatment. Results. The significant reduction of morning stiffness in patients with additional plasmapheresis was found (p<0.05). We determined the positive dynamics in articular syndrome assessing: VAS for pain decreased for 45.7% in 2st group (p<0.05), and for 53.3% in 1nd group (p<0.05). Severity of morning stiffness by VAS decreased for 58.4% (p<0.05) in 2st group and for 33.7% (p<0.05) in 1nd group. After 3 months of the therapy stopping of the psoriasis progression and regression of psoriatic lesions were observed. Conclusions. Combined treatment of plasmapheresis with basic therapy with methotrexate in patients with psoriatic arthritis was effective. The diclofenak and nimesulide tolerance was good and satisfactory. The adverse events observed were dyspeptic syndrome, increasing of alanine aminotransferase and mild imparing of the glomerular filtration.
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