Faculty of Medicine

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Access type: UnknownAuthor: search.filters.author.Baskim Osmani

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    PREVENTION OF BONE MINERAL LOSS IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES
    (Македонско лекарско друштво = Macedonian Medical Association, 2020)
    ;
    Filip Guchev
    ;
    Mimoza Nicolovska-Kotevska
    ;
    Dubravka Antova
    ;
    Introduction. Corticosteroids are therapeutic support for many medical conditions including systemic inflammatory rheumatic diseases. Secondary osteoporosis is one of the major complications from this therapy. Bisphosphonates are indicated for prevention and treatment of corticosteroid-induced osteoporosis. Aim. In a retrospective cross-sectional study to assess the effect of the early use of bisphosphonates on bone mineral density in patients with inflammatory rheumatic diseases treated with corticosteroids. Methods. We compared bone mineral density in an examined group of 75 posmenopausal women with inflammatory rheumatic diseases on a corticosteroid therapy who were treated early with bisphosphonates, with a control group of 80 postmenopausal women with osteoarthritis who have never been treated with corticosteroids. Bone mineral density was measured at the lumbar spine and left femur using Dual X-Ray absorptimetry in both groups of subjects. Results. Patients with inflammatory rheumatic diseases had an average T-score at the lumbar spine of -2.19, and -1.41 at the left hip. The average T-score for the control group was -2.24 at the lumbar spine and -1.53 at the hip. Difference in T-score at the lumbar spine and the left hip between the two groups was 0.073 and 0.300 (P=0.639 and P=0.048), respectively. There was no statistically significant difference in the T-scores for both groups. Conclusion. Osteoporosis is more prevalent in patients with inlammatory rheumatic diseases, both at the hips and the spine. The early use of bisphosphonates in patients with inflammatory rheumatic diseases, especially in those who are on corticosteroids, can prevent the loss of bone mineral density
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    ACR20 AND ACR50 CRITERIA FOR THE ASSESSMENT OF TREATMENT RESPONSE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH METHOTREXATE
    (Македонско лекарско друштво = Macedonian Medical Association, 2019)
    ;
    Filip Guchev
    ;
    Snezhana Mishevska Percinkova
    ;
    ;
    Introduction. Multiple comparative studies have assessed the therapeutic effect of methotrexate (MTX) and have shown that it is the leading disease modifying anti-rheumatic drug (DMARD) in the treatment of rheumatoid arthritis (RA). A quantitative appraisal of the therapeutic response of this drug in a set period of time is of great importance. Aim. To make an assessment of the therapeutic response to MTX, by using the American College of Rheumatologists (ACR), ACR20 and ACR50 criteria, for a fixed time period, in patients with rheumatoid arthritis and long disease evolution. Methods. In this prospective study we examined 60 patients with RA, of which 30 with disease evolution less than one year (average disease duration 5.1+/-2.8 months, 2-11 months), and 30 with disease duration over 5 years (average disease duration 7.9+/-1.8 years, 5-12 years). They were treated with an average dose of 7.5mg MTX weekly and non-steroid anti-inflammatory drugs (NSAID) as needed. In patients with early RA, MTX was used for the first time. At baseline all patients had active disease. ACR20 and ACR50 were assessed in all patients for the duration of the study. Results. After one year 26 (86.7%) of patients with early RA had satisfied ACR20 criteria compared to 18 (62.1%) of the patients with late arthritis. After two years this changed to 25 (83.3%) vs. 20 (69%) patients, respectively. ACR50 criteria after one year of treatment were satisfied in 12 (40%) patients with early arthritis and 8 (27.6%) with late arthritis, over 5 years of disease evolution. After two years data showed 21 (70%) vs. 10 (34.5%) patients, respectively. Conclusion. Early application of MTX in patients with arthritis allows for significantly better improvement in patients with RA compared to the use of the same treatment in those with a longer evolution of the disease.