PRACA PRZEGLĄDOWA
Zaburzenia gospodarki węglowodanowej u chorych na reumatoidalne zapalenie stawów i zesztywniające zapalenie stawów kręgosłupa – wpływ stosowanego leczenia
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Data nadesłania: 28-07-2013
Data ostatniej rewizji: 13-02-2014
Data akceptacji: 13-03-2014
Data publikacji online: 04-06-2014
Data publikacji: 30-04-2014
Reumatologia 2014;52(2):129-135
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Przewlekły stan zapalny w reumatoidalnym zapaleniu stawów i zesztywniającym zapaleniu stawów kręgosłupa leży u podstaw przyspieszonej miażdżycy naczyń, insulinooporności i jej następstw. Na zaburzenia metabolizmu glukozy w obu tych chorobach istotny wpływ może mieć stosowana farmakoterapia. W artykule przedstawiono doniesienia kliniczne dotyczące badań nad wpływem leków modyfikujących przebieg choroby, w tym leków biologicznych, glikokortykosteroidów (GKS) oraz powszechnie stosowanych niesteroidowych leków przeciwzapalnych (NLPZ), na insulinooporność oraz zaburzenia gospodarki węglowodanowej. Większość z nich dowodzi korzystnego w tym zakresie działania hydroksychlorochiny, metotreksatu oraz inhibitorów czynnika martwicy nowotworów (tumor necrosis factor – TNF), ze szczególnym uwzględnieniem infliksymabu. Protekcyjne działanie w postaci zmniejszenia ryzyka rozwoju cukrzycy mogą wykazywać także NLPZ. Ostatnie badania dowodzą, że wbrew powszechnej ocenie korzyści z zastosowania GKS, zwłaszcza w początkowym, aktywnym stadium choroby, mogą przeważać nad ich negatywnymi skutkami w zakresie gospodarki węglowodanowej.
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