Rheumatoid Arthritis: Curković B

Babić-Naglić D, Laktasić N, Jajić Z, Anić B, Morović-Vergles J, Curković B, Anonymous00257. · Klinika za reumatske bolesti i rehabilitaciju Medicinskoga fakulteta Sveucilista u Zagrebu, KBC Zagreb, Kispatićeva 12, 10000 Zagreb. · Reumatizam. · Pubmed #18450273 No free full text.

Abstract: Spondyloarthritides (SpA) as a group are one of the most common rheumatic disorders with a predominant affection of the spine. Conventinal disease modifying antirheumatic drugs which are effective in rheumatoid arthritis have poor effect on spinal inflammation. Today there is confirmed efficacy ofbiologics in spondylitis. This therapy is expensive and potentially hazaradous. Croatian Society for Rheumatology set up recommendations for the use of TNF-alpha blockers in SpA. There are several important points to be considered before their use: diagnosis of Spa, duration and disease activity, previous therapy and it's efficacy, application and efficacy ofbiologics, contraindications and safety preacutions and finally a decision for continuous tretament with biologics.

Curković B, Babić-Naglić D, Morović-Vergles J, Anić B, Grazio S. · Hrvatsko reumatolosko drustvo HLZ-a, Subićeva 9, 10000 Zagreb. · Reumatizam. · Pubmed #18450272 No free full text.

Abstract: Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is characterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology of the disease is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFalpha). TNFalpha blockers have documented, fast and continuous efficacy with generaly well accepted safety profile. Nowadays, TNFalpha antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFalpha antagonists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of the Croatian Society for Rheumatology we propose recommendations for the TNFalpha antagonist therapy in rheumatoid arthritis.

Curković B. · Klinika za reumatske bolesti i rehabilitaciju, Referentni centar MZSS RH za reumatoidni artritis, Klinicki bolnicki centar Zagreb. · Reumatizam. · Pubmed #19024273 No free full text.

Abstract: The main objectives of the current treatment of rheumatoid arthritis are disease control, inhibition of radiographic progression and finally remission. Presumptions to achieving these goals are early diagnosis of rheumatoid arthritis and early administered therapy with disease modifying drugs as monotherapy or combination of drugs. The optimal therapeutic response is influenced by tight control of the patients, evaluation of efficacy and tolerability and change of therapeutic strategy as needed. For the patients refractory to standard disease modifying drugs anti-TNFa drugs can be added. The choice of anti-TNFalpha drug should be done regarding efficacy, tolerability and method of drug administration. In a patient who is failing to respond after 3 months to one anti-TNFalpha we can try other one or rituximab.

Curković B, Babić-Naglić D, Morović-Vergles J, Anić B, Grazio S. · Hrvatsko reumatolosko drustvo HLZ-a, Subićeva 9, 10000 Zagreb. · Reumatizam. · Pubmed #19024266 No free full text.

Abstract: Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is caracterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFalpha). TNFalpha blockers have documented, fast and continuous efficacy with generally well accepted safety profile. Nowdays, TNFalpha antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFalpha antagonists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of Croatian Society for Rheumatology we propose recommendations for the TNFalpha antagonist therapy in rheumatoid arthritis.

Laktasić-Zerjavić N, Anić B, Curković B, Babić-Naglic D, Nola M, Loncarić D. · Klinika za reumatske bolesti i rehabilitaciju Medicinskog fakulteta, KBC Zagreb. · Lijec Vjesn. · Pubmed #17695193 No free full text.

Abstract: We report a case of primary Sjögren's syndrome (SSjö with cutaneous leukocytoclastic vasculitis. The accurate diagnosis of SSjö was established based on objective signs and symptoms of ocular and oral dryness and characteristic appearance of a biopsy sample from a minor salivary gland, and presence of anti-SS-A autoantibody. Another autoimmune disorder was not present, so diagnosis of primary SSjö was established. Histologic finding of skin biopsy of purpuric lesion was typical for leukocytoclastic vasculitis. The patient was treated with small doses of glucocorticoids and with local symptomatic therapy for ocular and oral dryness. SSjö is one of the most common autoimmune disorders and vasculitis is one of the most characteristic extraglandular manifestations, but wide spectrum of cutaneous involvement in primary SSjö has been little studied.

Pavlović R, Curković B, Babić-Naglić D, Kehler T. · Specijalna bolnica za medicinsku rehabilitaciju, Gajeva 2, 49217 Krapinske Toplice. · Reumatizam. · Pubmed #17580545 No free full text.

Abstract: Nonsteroidal anti-inflammatory drugs are the first choice in the tretment of rheumatic diseases. Nonsteroidal-antiinflammatory drugs show high efficacy, but they could be responsible for gastrointestinal and cardiovascular adverse events. When the gastrointestinal risk is generally accepted, cardiovascular risk is still without consensus. Did the discussion about potential cardiovascular risk with nonsteroidal anti-inflammatory drugs influenced their prescription in real life? Data on 201 patients with rheumatoid arthritis show that the prescription of nonselective, nonsteroidal anti-inflammatory drugs remain unchanged. More than two third of the patients use nonsteroidal anti-inflammatory drugs despite they have established cardiovascular disease.

Zerjavić NL, Juresa DS, Babić-Naglić D, Curković B, Potocki K, Zunec R, Ivanisević G. · Klinika za reumatske bolesti i rehabilitaciju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb. · Reumatizam. · Pubmed #16689106 No free full text.

Abstract: Genetic association between particular HLA-DRB1 genes and severity of rheumatoid arthritis (RA) has been documented in various clinical investigations. Susceptible alleles are *0401, *0404, *0405, *0408, *0101, *1001, *1402. According to the Shared epitope hypothesis presence of these alleles were considered as poor prognostic sign. The aim was to investigate HLA-DRB1 distribution in Croatian arthritis patients. Group of 90 patients with non-specific joint arthritis, non-erosive RA and erosive RA were typed for DRB1 alleles by PCR-SSP method. Susceptible alleles were identified in 58 (64.44 %) patients. The most frequent genes were DRB1 *0101 (43.33 %), *0401 (17.77 %), *0404 (10 %). 9 out of 58 DRB1* positive patients had 2 susceptible alleles, and the rest (49 patients) had only one susceptible allele. The patients with non-specific joint arthritis and non-erosive RA will bee closely followed for more destructive disease course in DRB1* positive patients.

Babić-Naglić D, Potocki K, Curković B. · Department of rheumatology University hospital Rebro Kispaticeva 12 CRO-Zagreb 10000, Croatia. · Z Rheumatol. · Pubmed #10502018 No free full text.

Abstract: Atlantoaxial (AA) instability is frequent radiological finding in patients with rheumatoid arthritis (RA). Mostly no serious neurological disorders are expected in such patients. The purpose of the study was to assess the sagittal spinal canal diameter according to Steel's rule of third and its relationship to clinical symptoms. Radiological and clinical evaluation was performed in 65 in-patients with RA. Fifty four patients complained of neck pain, 39 had vertebrobasilar symptoms, and 25 mild neurological disorders. Hyperreflexy tendon responses were registered in 16 patients. Only 1 patient had extensor plantar response. Forward AA dislocation was verified in 28 (43%) cases with a mean value of 8.3mm (4-17 mm). Still free space for spinal cord in spinal canal was obtained in 62 (95%) of patients, which can explain such a low incidence of serious neurological disorders.Our results suggest an association among duration of disease, atlantodental distance, and sagittal spinal canal diameter. We consider that it is important to detect early the most jeopardized patients on the basis of radiological analysis at C1 level according to Steel's rule of third and recognize when rising dbl quote, left (low)safe zone" has exceeded and enters the area of impending spinal cord compression.