[A comparative evaluation of combined immunocorrective therapy in rheumatoid arthritis with systemic manifestations (joint Soviet-Polish research)]. / Sravnitel'naia otsenka kompleksnoi immunokorrigiruiushchei terapii revmatoidnogo artrita s sistemnymi proiavleniiami (sovmestnoe sovetsko-pol'skoe issledovanie).

Thirty-two patients with rheumatoid arthritis were included in the trial. Each of them was assigned to one of the 4 groups comparable by the main features. Each group entered 8 patients. Group 1 patients underwent hemosorption weekly for 3 weeks. After the second procedure cyclophosphamide was added at a single IV dose 1000 mg. After the third procedure the treatment was continued with methotrexate (7.5 mg, weekly). Group 2 began the treatment with methotrexate (7.5 mg, weekly). Group 3 received cyclophosphamide 200 mg IV twice a week 6 times and then 200 mg weekly orally till a total dose of 2 g. Group 4 received azathioprine in a daily dose 100 mg. The treatment with nonsteroidal antirheumatic drugs and corticosteroids was continued unchanged. After 6 months we did not see significant differences between the 4 groups.

A trial of cyclophosphamide in ankylosing spondylitis with involvement of peripheral joints and high disease activity.

In 12 patients with ankylosing spondylitis with involvement of the peripheral joints and high activity of the disease process, cyclophosphamide was given in intravenous doses of 200 mg every second day for 3 weeks, followed by oral doses of 100 mg once weekly for 3 months to a total dose of 3 300 mg. Before this treatment and after 18-24 months the following clinical parameters were determined: spinal mobility, degree of intensity of spinal and articular pains, and the number of involved joints. After the treatment an evident clinical improvement was observed, with decreased values of the laboratory indices of the disease activity. Apart moderate erythrocyturia in one case and transient leukopenia in another case, no other side effects were observed. The improvement in cases with coexistent amyloidosis was relatively small.

Latent collagenase of rheumatoid synovial fluid is not of granulocytic origin.

The physicochemical properties of three latent collagenases derived from rheumatoid synovial fluid, polymorphonuclear leucocytes and culture medium of rheumatoid synovium were compared. It has been shown that synovial fluid enzyme is similar to that of synovium collagenase from tissue culture and differs significantly in molecular size and protein charge from granulocyte collagenase. The results indicate that the latent, trypsin-activable collagenase present in rheumatoid synovial fluid is not of granulocytic origin and seems to derive from the synovial membrane.

Clinical symptoms and signs useful in the early diagnosis of ankylosing spondylitis.

Seventy patients between the ages of 18 to 30 with early spondylitis (eAS), with bilateral grade II-III sacroiliitis without syndesmophytes were examined. The control group comprised 32 patients of the same age range with lumbar disc disease (LDD) confirmed by radiculography, without changes in the sacroiliac joints. In both groups the same clinical parameters were evaluated, calculating for each the specificity, sensitivity and Youden index. Statistical analysis was done using Student's t-test and/or the chi-square test. A complex of simple clinical features was isolated suggesting presence of eAS in young subjects with persistent low back pain but without a clear-cut radiological appearance of the sacroiliac joints. The complex included: a history of morning back stiffness, swelling of knee joints, thoracic pain, clinical evidence of limited chest expansion below 5 cm, swelling of joints of lower extremities, positive Mennell's sign, and in laboratory investigations presence of raised ESR and HLA B27-antigen.

[Azapropazone versus indomethacin in a double blind test with patients with ankylosing spondylitis]. / Azapropazon Versus Indometacin im Doppelblindversuch bei Patienten mit Spondylitis ankylosans.

In a double lind test 60 patients with ankylosing spondylitis received either Azapropazone (30 patients) or Indomethacin (30 patients) during a period of three weeks. In the two well comparable groups the therapeutic effect was equally good. As the results show the Azapropazone group came out a little better concerning the finger-ground distance and the difference in circumference of thorax, and the Azapropazone group was favoured slightly by the general judgement of the patients. However, these differences are not relevant. The influence on the spontaneous pain in the daytime and during the night and the shifting of dorsal and lumbar vertebral column was equally good in both groups. The compatibility was good in 59 out of 60 patients. One patient had to stop the Azapropazone medication because of gastric trouble in the second week of treatment. This result shows that in most patients an adequate medication with Azapropazone or with Indomethacin leads to a distinct reduction of pain and even painlessness already after a 3 weeks' treatment. This is particularly important regarding kinesiatrics. Indomethacin and Phenylbutazone are generally regarded as approved preparations in treatment of ankylosing spondylitis. If Azapropazone which, according to all previous reports has no hematotoxic effect like Phenylbutazone, had the same good effect in a double blind test as Indomethacin, this must be regarded as a very positive result. Concerning the good compatibility of Azapropazone, a change of drug is possible without a reduction of the effect.