COMPREHENSIVE TREATMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS AND COMORBID CONDITIONS

Abstract

Rheumatoid arthritis (RA) is the most common and disabling rheumatic disease. Managing RA patients is a complex diagnostic and therapeutic process. The presence of a comorbid (polymorbid) status in RA patients significantly complicates the work of the physician and significantly reduces the quality of life of patients. When managing such patients, it is necessary to consider not only the severity of the underlying disease, but also the presence of a comorbid pathology that can complicate the diagnostic search, as well as the choice of targeted therapy. This work presents the clinical observation of a patient with seropositive. RA with extra- articular manifestations in the late stage of the disease associated with a previous tuberculosis infection. The clinical picture of the disease, modern diagnostic criteria, and the main groups of medications used to treat RA are examined. The experience of using rituximaba and its effects has been demonstrated. The complexity of the treatment process was the selection of the drug, as well as the late initiation of adequate treatment. In our clinical observation, the correct selection of genetic engineering biological therapy was accompanied by a significant positive effect in the form of a decrease in the intensity of joint syndrome, acute phase, and immunological activity of the disease. Treatment did not worsen the course of comorbid conditions. Rituximabe in this patient was the drug of choice due to the high immunological activity and acute phase of the disease, the risk of reactivation of the tuberculosis infection.