The article presents current data on algorithms for managing patients with the most common forms of spondylarthritis — ankylosing spondylitis, axial spondylarthritis and psoriatic arthritis, based on existing national and European recommendations. The analysis of innovative approaches to the patho‑genetic therapy of spondyloarthritis with special attention to the inhibition of interleukin‑17 using the drug secukinumab. Along with the literature data, there is a clinical experience of using secukinumab in patients with ankylosing spondylitis, axial spondyloarthritis, and psoriatic arthritis. It has been shown that secukinumab can improve the quality of treatment and achieve clinical remission in patients with high disease activity and adverse prognostic factors. In connection with the high efficacy and safety of treatment, the feasibility of using secukinumab as a first‑line biological agent with insufficient response to a standard basic drug is discussed.

This article presents the results of international studies of abatacept efficacy and safety and searching for possible predictors of a good response to the therapy with this drug in real clinical practice.

Osteoarthritis and osteoporosis are widespread diseases of musculoskeletal system among older patients leading in many cases to disability. The patients may often suffer from both osteoarthritis and osteoporosis. Non‑drug ways of treatment of these diseases attract more and more attention because of their effectiveness and low costs. The weakness of periarticular muscles plays a significant role in the osteoarthritis development. Strengthening of them has an important influence in multiple treatment of the disease. Physical exercises in case of osteoporosis promote patients’ functional abilities and improvement in their quality of life.

The article is devoted to the study of the degree and pattern of irreversible changes in the organs and systems of the body using the SLICC damage index in patients with systemic lupus erythematosus (SLE) and systemic scleroderma (SSc) with a disease duration of more than 5 years. Data were obtained from a high incidence of adverse changes in patients with SLE and SSc. In patients with SLE, adverse changes in the cardiovascular system, central nervous system in the form of acute cerebral circulation disorders and seizures, as well as venous thrombosis, damage to the organ of vision in the form of cataracts, proteinuria (more than 3.5 g per day) and alopecia prevailed. Patients with SSc more often developed lesions of the respiratory organs in the form of pulmonary fibrosis and pulmonary hypertension, the musculoskeletal system, skin and neuropathy of the cranial nerves and peripheral nerves.

Psoriatic arthritis forms part of the spondyloarthritis spectrum and is characterized by heterogeneity of clinical picture. According to epidemiological studies, patients with psoriatic arthritis often suffer from numerous comorbidities, which affect the quality of life, impact on the response to therapy and are the main cause of increasing mortality. The studies assessing the relation between psoriatic arthritis course and comorbidity are in interest nowadays, because this issue has not been studied enough in comparison with other chronic inflammatory arthritis. Comorbidity includes cardiovascular diseases, diabetes mellitus, obesity, metabolic syndrome, osteoporosis, liver diseases, inflammatory bowel disease, depression, etc. Timely diagnosis and control of comorbidity will reduce the development of complications and improve clinical outcome.

A wide range of highly effective genetically engineered biological preparations introduced into clinical rheumatology in recent years causes a special interest in their safety.

Purpose of the study. Evaluation of the safety of infliximab therapy in patients with rheumatoid arthritis.

Materials and methods. The authors' own data, which analyzed the undesirable effects of infliximab in 135 patients with rheumatoid arthritis in actual clinical practice, are presented. A case report of the adverse reaction of combination therapy with leflunomide and infliximab is presented.

Results and its discussion. The overall tolerability of infliximab was satisfactory. Adverse events were observed in 28.1 % of cases, including 19.1 % of patients (14.1 %) had serious side effects that required discontinuation of the drug.

Findings. In most cases, infliximab is safe for use in actual clinical practice. Patients should be informed about the risks of undesirable effects and the need for a rheumatologist's examination before each infliximab administration before prescribing therapy.

130 rheumatoid arthritiS patients (RA pts) were distributed in the comparative groups on the basis of used physiotherapy methods and placebo‑physiotherapy. Violation of peripheral blood‑flow mainly vessels of small and medium caliber mainly vessels of small and medium caliber in RA pts in comparison with group of practically healthy persons at baseline was detected, the severity of these abnormalities depended on duration of disease. The comparative analysis of basic rheovasographic indexes in RA pts before and after treatment in parallel groups treated with electrosleep‑therapy, low‑frequency magnetotherapy, bioresonant stimulation and placebo‑physiotherapy was conducted. Significant differences in studied indexes after completed course of treatment such as diminishing of asymmetry of blood‑filling in extremities at all types of physiotherapy, increasing of pulse vascular blood‑filling of extremities after electrosleep‑therapy and bioresonant stimulation, decrease of vascular tonus after application of low‑frequency magnetotherapy were defined. Course of placebo‑physiotherapy has not demonstrated statistically meaningful changes in rheovasographic indexes. Clinically significant adverse events during physiotherapy treatment were not detected. Conclusion: including of physiotherapy in the management of RA pts in term to improve peripheral hemodynamics and to prevent vascular complications can be recommended.

Idiopathic lobular panniculitis (ILP or Weber‑Christian disease) is the least studied disease in the group of systemic connective tissue lesions and is characterized by systemic lesions of subcutaneous fat. The examination of 67 patients (9 men and 58 women aged 20 to 76 years) with a verified diagnosis of ILP allowed to identify the main clinical and laboratory signs of ILP.