EFFECTIVENESS OF TREATMENT OF PATIENTS WITH ANKYLOSING SPONDYLITIS COMORBID WITH ALEXITHYMIA

Vasylets V.V., Станіславчук М.А.

• National Pirogov Memorial Medical University, Vinnytsya

Summary. Research into factors influencing the effectiveness of ankylosing spondylitis treatment is an effective means of improving treatment measures for this disease. The aim: to assess the effectiveness of treatment of patients with ankylosing spondylitis comorbid with alexithymia. Materials and methods. 127 patients with ankylosing spondylitis were clinically examined: 62 with no alexithymia, 29 with possible alexithymia, and 36 with alexithymia. The effectiveness of treatment was assessed. Results. Better dynamics of activity, functional ability and health status of patients without alexithymia were found compared to patients with possible alexithymia and with the presence of alexithymia, which was manifested by a decrease in ESR from 26.44±16.34 mm/h to 16.89±8.64 mm/h, from 25.93±16.77 mm/h to 18.21±10.01 mm/h, and from 33.50±18.55 mm/h to 23.47±12.98 mm/h; BASDAI from 4.80±1.86 points to 4.15±1.78 points, from 5.87±1.77 points to 5.13±1.71 points, and from 6.91±1.83 points to 6.03±1.55 points; ASDAS-ESR respectively from 3.22±0.91 points to 2.78±0.78 points, from 3.59±0.89 points to 3.11±0.78 points, and from 3.94±0.79 points to 3.53±0.80 points; BASMI respectively from 3.27±1.48 points to 2.65±1.42 points, from 4.00±1.63 points to 3.52±1.55 points, and from 5.22±2.07 points to 4.61±1.95 points; BASFI respectively from 4.42±2.31 points to 3.75±2.26 points, from 5.56±1.75 points to 4.87±1.83 points, and from 6.39±1.87 points to 5.48±2.04 points; BAS-G 7 days respectively from 5.61±2.15 points to 4.31±1.95 points, from 6.69±1.93 points to 5.48±1.81 points, and from 7.42±1.65 points to 6.44±1.66 points; BAS-G 6 months respectively from 5.77±2.15 points to 5.29±2.18 points, from 6.59±1.80 points to 6.03±2.11 points, and from 7.17±2.04 points to 6.67±2.00 points; ASAS HI respectively from 7.21±3.15 points to 6.15±3.10 points, from 8.93±2.34 points to 7.69±2.30 points, and from 10.58±3.66 points to 8.50±3.84 points; ASAS EF respectively from 2.76±1.36 points to 2.29±1.11 points, from 3.59±1.24 points to 2.79±1.05 points, and from 4.08±1.36 points to 3.44±1.46 points; HAQ respectively from 0.87±0.59 points to 0.82±0.60 points, from 1.28±0.59 points to 1.05±0.56 points, and from 1.57±0.57 points to 0.95±0.53 points; VAS pain, respectively, from 5.90±1.87 points to 4.82±1.79 points, from 7.00±1.51 points to 5.66±1.29 points, and from 7.78±1.15 points to 6.44±1.44 points. Standard therapy allowed achieving compliance with ASAS 20 criteria in 38.7% of patients without alexithymia, in 20.7% of patients with possible alexithymia, and in 13.9% of patients with alexithymia, with ASAS 40 criteria — in 11.3%, 3.4%, and 2.8% of patients, respectively. Standard therapy significantly improved the quality of life and psychoemotional state of patients, as well as TAS-20 alexithymia scale. The best dynamics of treatment was found in patients without alexithymia, and the worst in patients with alexithymia. Conclusions. Standard treatment of ankylosing spondylitis allows to achieve a decrease in activity, improve functional capabilities, health status and quality of life of patients, and reduce the severity of psychopathological manifestations associated with ankylosing spondylitis, while alexithymia is an actual factor of resistance to treatment.