Rheumatoid Arthritis: Jajić Z

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.

Jajić Z, Malaise M, Nekam K, Koó E, Dankó K, Kovacs M, Scarpignato C. · Department for Rheumatology, Physical Medicine and Rehabilitation, Medical Faculty University of Zagreb, Referral Centre for Inflammatory Rheumatic Disease, Zagreb, Croatia. · Clin Exp Rheumatol. · Pubmed #16396699 No free full text.

Abstract: OBJECTIVE: Selective inhibitors of cyclo-oxygenase-2 (COX-2) appear to be safer than conventional NSAIDs on the gastrointestinal (GI) tract. Amtolmetin guacyl (AMG), a NSAID that inhibits both COX-1 and COX-2, has an anti-inflammatory effect comparable to that of traditional NSAIDs, with a better GI safety profile. The primary end-point of this study was to evaluate the gastrointestinal safety of amtolmetin guacyl in comparison with celecoxib in patients affected with rheumatoid arthritis. The assessment of efficacy was the secondary end-point. METHODS: This study was a 24-week, randomized, parallel group, double-blind, double dummy, multicentre trial; 235 patients were enrolled and 180 patients (85 in the AMG group and 95 in the celecoxib group) completed the study. Each patient received twice daily amtolmetin guacyl 600 mg or celecoxib 200 mg. Assessment of safety was performed by upper GI endoscopy, gastrointestinal symptoms evaluation, electrocardiography, blood and urine laboratory tests, adverse events recording. Assessment of efficacy was performed by using the American College of Rheumatology (ACR-20) responder index. RESULTS: Neither amtolmetin guacyl nor celecoxib determined a worsening of baseline gastro-duodenal endoscopy findings. The percentage of patients with normal findings did not significantly change after treatment with both drugs, being virtually identical with AMG (i.e. 75.29%) and increasing from 75.79% to 77.66% with celecoxib. Moreover an evaluation of the other safety parameters did not reveal any difference between the two treatment groups. Therapeutic efficacy was equivalent in both groups, with no statistical difference between the two drugs at all time intervals. CONCLUSIONS: In patients affected with rheumatoid arthritis, AMG and celecoxib proved to be equivalent, showing comparable gastrointestinal safety and therapeutic efficacy of treatment.

Grazio S, Grubisić F, Jajić Z. · Klinika za reumatologiju, Referentni centar za upalne reumatske bolesti Ministarstva zdravstva RH Klinicka bolnica Sestre milosrdnice, Vinogradska 29, 10000 Zagreb. · Reumatizam. · Pubmed #15072038 No free full text.

Abstract: The comparison of standard high frequency (ST-TENS) and acupuncture-like TENS (AL-TENS) in patients with rheumatoid arthritis is presented. Thirty-three patients (26 women and 7 men) with rheumatoid arthritis (according to modified ACR criteria), and with the duration of the disease 10.7 +/- 8.8 years are investigated. Each subject received ST-TENS (75 Hz) at the selected joint and AL-TENS (4 Hz) at the contralateral joint respectively. No significant difference between left and right side in pre-treatment pain was the main criterion for selecting the treated joint. Treatment was performed during 12 days. The initiation, duration, level of hypolgesia (according to Ritchie's pain assessment scale and VAS), patients' global assessment and possible reduction of dosage of analgetics/antirheumatics were measured. There was a significant reduction in pain level on ST-TENS site (48.6%), and on AL-TENS site (40.8%), measured on VAS. Results of Ritchie's index showed significant difference before and after application (for each type of TENS P < 0.05). There was no statistical difference between both types of TENS regarding the reduction of pain level, as well as the initiation of analgesic effect, whilst it was noted a slightly longer, although statistically not significant, hypoalgesic effect of AL-TENS. Patients' global assessment also did not differ relating to ST-TENS and AL-TENS, as well as their opinion on possible dosage reduction of analgetics/antirheumatics. Side effects for both types of TENS were negligible. The findings showed that ST-TENS and AL-TENS provided hypoalgesic effect in the similar degree in patients with long-standing rheumatoid arthritis.

Babić-Naglić D, Jajić Z, Gnjidić Z, Stambuk B. · Klinika za reumatske bolesti i rehabilitaciju, KBC Zagreb, Zagreb. · Reumatizam. · Pubmed #12476759 No free full text.

Abstract: Incorrect treatment of chronic pain is common cause of patient's discontentment and suffering. The problem is mostly occurring because of inappropriate pain treatment. The WHO guidelines recommends declining of prejudices and using of strong opioids in therapy after the unsatisfactory treatment with weaker analgesics. Strong opioid analgesic fentanyl in transdermal system (Durogesic TTS) is introduced. In rheumatology, it is recommended for all conditions characterised by chronic pain with intensity 4 and more on the VAS scale (0-10). It is mostly used in rheumatoid arthritis, osteoarthritis, low back pain and neuropathic pain. Durogesic TTS provides continuous pain relief for 72 hours, with constant serum concentrations. It has to be gradually titrated and starting dose is 25 micrograms/h. Possible adverse events (nausea, vomiting, constipation, sedation, itching) are short termed, transitory and easily managed. Results of some clinical trials and personal experiences that are proving its efficacy and safety are presented.