2025-3-58-68

УДК 616.72-002.77:615.276:[616.33/.342-002.446]
DOI: https://doi.org/10.52540/2074-9457.2025.3.58
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Р. А. Павлюков, М. Р. Конорев, М. В. Сазонов

Витебский государственный ордена Дружбы народов медицинский университет, г. Витебск, Республика Беларусь

Целью данного исследования было прогнозирование вероятности развития нежелательных лекарственных реакций (эрозий и язв желудка и двенадцатиперстной кишки) у пациентов с ревматоидным артритом на фоне терапии мелоксикамом. В исследование было включено 160 пациентов с диагнозом ревматоидный артрит, которые при наличии болевого синдрома принимали мелоксикам длительно – более 3 раз в неделю на протяжении более 3 месяцев. Длительность наблюдения составила от 4 до 8 лет. Обследуемые были распределены на подгруппы с учетом наличия ревматоидного фактора и инфицирования Helicobacter pylori. Анализ данных показал, что у пациентов с серопозитивной формой ревматоидного артрита существенно чаще развивались эрозивные и язвенные изменения слизистой желудка и двенадцатиперстной кишки на фоне терапии мелоксикамом, в сравнении с пациентами с серонегативным ревматоидным артритом. Кроме того, установлено, что ревматоидный фактор является надежным прогностическим показателем для предсказания риска развития нежелательных реакций (гастродуоденальных эрозий и язв) на фоне терапии мелоксикамом для купирования болевого синдрома, независимо от наличия инфекции Helicobacter pylori. В общей группе пациентов характеристики ревматоидного фактора как прогностического индикатора составили: чувствительность 93,9%, специфичность 86,1% и доля правильных прогнозов 89,4%. Сделан вывод, что ревматоидный фактор является достоверным прогностическим показателем для предсказания развития нежелательных реакций (гастродуоденальных язв и эрозий) у пациентов с ревматоидным артритом на фоне приема нестероидных противовоспалительных препаратов (мелоксикам) в качестве симптоматической терапии независимо от наличия инфекции Helicobacter pylori.

Ключевые слова: ревматоидный фактор, ревматоидный артрит, мелоксикам, нежелательные реакции, эрозии, язвы, желудок, двенадцатиперстная кишка.

SUMMARY

A. Pavlyukov, M. R. Konorev, M. V. Sazonov

PREDICTION OF RISK OF ADVERSE REACTIONS DEVELOPMENT (GASTRODUODENAL EROSIONS AND ULCERS) IN PATIENTS WITH RHEUMATOID ARTHRITIS TAKING MELOXICAM

This research aimed at prediction of the likelihood of developing adverse drug reactions (erosions and stomach and duodenal ulcers) –in patients with rheumatoid arthritis undergoing meloxicam treatment. The research included 160 patients with confirmed rheumatoid arthritis who took meloxicam for a long period of time while having painful syndrome more than 3 times a week for more than 3 months. The duration of monitoring made 4 to 8 years. The participants were categorized into subgroups based on the presence of rheumatoid factor and Helicobacter pylori infection. The data results showed that patients with seropositive rheumatoid arthritis compared to the patients with seronegative rheumatoid arthritis had a significantly higher development of erosive and ulcerative changes in the mucous membrane of the stomach and duodenum when taking meloxicam. In addition, rheumatoid factor was found to be a reliable prognostic marker for predicting the risk of adverse reactions (gastroduodenal erosions and ulcers) against the background of meloxicam therapy for pain relief regardless of the presence of Helicobacter pylori infection. In the total group of patients the characteristics of rheumatoid factor as a prognostic indicator were: sensitivity 93.9%, specificity 86.1% and proportion of correct predictions 89.4%. It was concluded that the rheumatoid factor is a reliable prognostic indicator for predicting the development of adverse reactions (gastroduodenal ulcers and erosions) in patients with rheumatoid arthritis while taking non-steroidal anti-inflammatory drugs (meloxicam) as symptomatic therapy regardless of the presence of Helicobacter pylori infection.

Keywords: rheumatoid factor, rheumatoid arthritis, meloxicam, adverse reactions, erosions, ulcers, stomach, duodenum.

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