The subject of the investigation is a connection between the levels of anticitrulline antibodies, rheumatoid factor, acute-phase reactants in blood and clinical and radiological course, functional disorders and response to the treatment by basic drugs in patients with rheumatoid arthritis; the object of the investigation is improvement of treatment of patients with rheumatoid arthritis by basic drugs according to comparative evaluation of the clinical effect and rate of progression of radiological changes in the joints depending on the levels of anticitrulline antibodies and rheumatoid factor during a long-term treatment by structure-modifying drugs; the methods are clinical, biochemical, immunological, radiological and statistical; the novelty and results are as following: for the first time on the grounds of predictor clinical and laboratory tests a new method of prediction of favourable or unfavourable clinical and radiological course of rheumatoid arthritis is designed, a prognostic importance of anticitrulline antibodies and their combinations with rheumatoid factor according to radiological efficiency of basic treatment is determined, for the first time a prospective, direct, comparative investigation of clinical and radiological efficiency of leflunomide, methotrexate, sulfasalazine, infliximab and their combinations in patients with rheumatoid arthritis depending on the level of anticitrulline antibodies and rheumatoid factor is made, a basic treatment is improved with the help of a composite determination of the level of anticitrulline antibodies and rheumatoid factor, an assessment of the clinical effect and the rate of progression of radiological destruction, the importance of determination of anticitrulline antibodies on initial stages of rheumatoid arthritis is proved, which is done for bone changes prediction in patients taking different basic drugs, an opportunity of individual prediction of clinical and radiological course of rheumatoid arthritis is shown on the basis of the assessment of serological biomarkers and markers of activity of the clinical course, recommendations on rational differentiated usage of leflunomide, methotrexate, sulfasalazine, infliximab and their combinations in patients with rheumatoid arthritis depending on the level of anticitrulline antibodies and rheumatoid factor in their blood are made, the investigation is put into clinical practice of "The Institute of Emergency and Plastic Surgery, named after Gusak of National Academy of Medical Sciences of Ukraine", the Donetsk Regional Clinical Territorial Medical Union, the University Clinic of the Donetsk National Medical University named after Gorky and the teaching process of the Donetsk National Medical University; the sphere of application of the investigation is diagnosing and treating process in rheumatoid and therapeutic departments, research and teaching in therapeutic faculties of medical educational establishments.
