Bukach O. Peculiarities of the course and optimization of treatment of rheumatoid arthritis concomitant with arterial hypertension, obesity and type 2 diabetes

The dissertation deals with the optimization of the treatment of 110 patients with rheumatoid arthritis (RA): 40 patients with RA without any concomitant pathology, 30 patients with RA and arterial hypertension (AH), 20 patients with RA, AH and abdominal obesity (AO), 20 patients with RA and AH, AO and type 2 diabetes mellitus (DM 2) based on the study of clinical peculiarities of the course, changes in the functional state of the endothelium, systemic inflammation markers, oxidant-antioxidant system, proteolytic and fibrinolytic activity of blood plasma, cytokine profile, lipid blood spectrum and genetic predictors. Application of Telmisartan, Rosuvastatin and L-arginine against the background of the baseline therapy in patients with RA concomitant with AH, AO and DM 2 and the correction of Rosuvastatin and L-arginine aspartate dose in CC-genotype carriers of T 786C gene promoter of eNOS contributed to the decrease in clinical manifestations of the disease, the achievement of positive dynamics of parameters of the cytokine profile, lipid spectrum of blood, functional state of the endothelium and improvement of patient’s quality of life. Key words: rheumatoid arthritis, arterial hypertension, abdominal obesity, type 2 diabetes, T-786C gene promoter polymorphism of endothelial nitric oxide synthase, diagnostics, treatment. Branch - Medicine.