Features of the course of rheumatoid arthritis and osteoarthritis in patients with asymptomatic hyperuricemia

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Abstract


Introduction. According to numerous studies, the prevalence of asymptomatic hyperuricemia has increased in most countries. Uric acid is an important biomarker of the cardiovascular system, and there are now quite a big number of sources indicating its role in the development of a some chronic metabolic conditions, cardiovascular disease and associated mortality. At present, there is no consensus on the need for urate-lowering therapy in patients with asymptomatic hyperuricemia. There is a limited number of studies examining the problem of asymptomatic hyperuricemia in patients with rheumatic diseases, the features of comorbidity in these conditions, the frequency and effectiveness of urate-lowering therapy.

Purpose. To study the peculiarities of the course of rheumatoid arthritis and osteoarthritis with associated asymptomatic hyperuricemia and compare them with the ones associated with arthragra.

Materials and methods. The analysis was performed on the basis of the data collected from the city register of the patients with arthragra and asymptomatic hyperuricemia in St. Petersburg. The data collected included the medical records of 1725 patients with arthragra, 433 patients with rheumatoid arthritis and hyperuricemia and 355 patients with osteoarthritis and hyperuricemia.

Results. The patients with rheumatoid arthritis and hyperuricemia were more likely to have increased erythrocyte sedimentation rate and C-reactive protein, the highest medium level of erythrocyte sedimentation rate; acute myocardial infarction, chronic heart failure, gallstone disease and non-alcoholic fatty liver disease were more frequently detected. The patients with osteoarthritis and hyperuricemia were more likely to have high total cholesterol, at its highest medium level; stable angina, arrhythmia, varicosity, obesity, prediabetes and type 2 diabetes mellitus were more likely to be detected. Kidney damage was detected more frequently in the patients with arthragra. In the group of rheumatoid arthritis and hyperuricemia urate-lowering therapy was started in 30.95% of the patients, in the group of osteoarthritis and hyperuricemia — in 36.06%.

Conclusions. In rheumatic diseases, hyperuricemia is a common associated condition. Their combination leads to increased risk and frequency of cardiovascular, metabolic and gastroenterological comorbidity. The prescription of urate-lowering therapy to the patients with rheumatic diseases and asymptomatic hyperuricemia with high cardiovascular risk led to the target uric acid levels in 34.58% of the patients with rheumatoid arthritis and 52.08% of the patients with osteoarthritis.


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About the authors

Vadim I. Mazurov

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482

Russian Federation, Saint Petersburg

Главный научный консультант, заведующий кафедрой терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им.Э.Э.Эйхвальда; руководитель центра аутоиммунных заболеваний, академик РАН, з.д.н. РФ, д.м.н., профессор.

Roman A. Bashkinov

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Author for correspondence.
Email: bashkinov-roman@mail.ru
ORCID iD: 0000-0001-9344-1304
SPIN-code: 5169-5066

Russian Federation, Saint Petersburg

Аспирант кафедры терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им.Э.Э.Эйхвальда; врач-ревматолог 

Alexandra Yu. Fonturenko

Clinical Rheumatology Hospital No. 25

Email: aleksa.fonturenko@mail.ru
ORCID iD: 0000-0003-4860-0518
SPIN-code: 5613-9035

Russian Federation, Saint Petersburg

Врач-ревматолог 

Inna Z. Gaydukova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: ubp1976@list.ru
ORCID iD: 0000-0003-3500-7256
SPIN-code: 3083-7996

Russian Federation, Saint Petersburg

Профессор кафедры терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им.Э.Э.Эйхвальда; д.м.н

Marianna S. Petrova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: podagra@bk.ru
ORCID iD: 0000-0001-5261-6614

Russian Federation, Saint Petersburg

доцент кафедры терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им.Э.Э.Эйхвальда, к.м.н.; Заместитель главного врача; руководитель «Городского клинического центра подагры»

Oksana V. Inamova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: b25@zdrav.spb.ru
ORCID iD: 0000-0001-9126-3639
SPIN-code: 8841-5496

Russian Federation, Saint Petersburg

ассистент кафедры терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им.Э.Э.Эйхвальда, к.м.н; Главный врач

Ivan M. Nagirnyak

LLC “TechLab”

Email: nagir@inbox.ru
ORCID iD: 0000-0002-3492-9067

Russian Federation, Saint Petersburg

Руководитель проектов

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Copyright (c) 2020 Mazurov V.I., Bashkinov R.A., Fonturenko A.Y., Gaydukova I.Z., Petrova M.S., Inamova O.V., Nagirnyak I.M.

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