Certain Indicators of Diclofenac Sodium Pharmacokinetics in Patients with Rheumatoid Arthritis Considering Comorbide States

Abstract

Introduction: Much attention is paid to pharmacokinetic (FK) researches for studying the processes of
supply, distribution, biotransformation and excretion of medications at the present time, as well as identifying
links between medical substances concentration and (or) its metabolites in biological fluids and tissues, and
its pharmacological effect. In the treatment of rheumatoid arthritis (RA), non-steroidal anti-inflammatory
drugs (NSAID) are widely used for a symptom therapy, where Diclofenac Sodium (DS) is most commonly
prescribed. Duration of anti-inflammatory effect, effectiveness of NSAID in whole are directly dependent on
the level of effective concentration of medications and circulation duration in blood in free form.
The Aim of the present research work is to study in a comparative aspect certain indicators of Diclofenac
Sodium pharmacokinetics in patients with rheumatoid arthritis with gastric microbiocenosis disorders
(gastric dysbiosis) and without disorders (without dysbiosis).
Materials and Method: 38 patients at the age from 18 to 60 years were examined, with I-II-III degree of
disease activity. In addition to the general clinical examination, an immune-enzyme method and urease test
were carried out to determine Helicobacter Pylori and highly effective liquid chromatography to determine
Diclofenac pharmacokinetics.
Results: Conducted researches and analysis of their results indicate that in conditions of rheumatoid arthritis,
particularly, in the presence of comorbid states, there is a decrease in the metabolism rate and an extension of
NSAID half-excretion period, which increases the risk of side effects, especially to the gastrointestinal tract,
and significantly affects the disease course and the results of the treatment.
Conclusion: In conditions of rheumatoid arthritis with comorbid states, there is more frequent occurrence
of the NSAID side effects. Research conducted and analysis of their results indicate that in conditions
of rheumatoid arthritis, particularly at comorbid states, there are reasonable changes in the NSAID
pharmacokinetics. The decreasing of metabolic rate and the extension of the NSAID half-excretion increases
the risk of side effects, especially on the side of the GIT, which significantly affects the disease course and
results of the treatment. This circumstance dictates the need to take these results into account in the treatment
of the studied pathology and in the development of a personalized approach to the treatment of rheumatoid
arthritis