AUTOIMMUNE COMORBID DISORDERS – THE OPPORTUNITIES OF RATIONAL TREATMENT

In this review of our own data we discuss the problems of the treatment of comorbid conditions using osteoarthritis (OA) and rheumatoid arthritis as examples. We provide a rationale for the use of drugs targeting central molecular nodules which regulate inflammation, immune reactions, lipid homeostasis, and herbal medicines directed on various targets. The results of clinical studies evaluating efficacy, safety and pharmacodynamics of these drugs are presented. The use of fenofibrate and simvastatin in rheumatoid arthritis was effective and well tolerated and was associated with anti-inflammatory and antiatherogenic effects. The use of fenofibrate in patients with erosive OA was associated with the reduction of pain, decreased markers of inflammatoion and had lipid modulating and immune modulating effects. Clinical efficacy and pleiotropic effects of fenofibrate were also observed in other OA phenotype – diabetes-associated OA. The results of clinical trials evaluating herbs Comarum Palustrae and Curcuma longa in OA with metabolic syndrome showed their efficacy, safety and pleotropic effects. The use of drugs targeting molecular hubs and herbal treatments are promising and pathogenetically based approaches to the treatment of autoimmune arthropathies with high risk of comorbidity.