The role of systemic enzymotherapy in the treatment of rheumatoid arthritis

Mazourov V.I., Lila A.M., Klimko N.N., Raimue K.V., Makulova T.G.

Medical Academy of Postgraduate Education, Military Medical Academy, City Rheumatological Center, St. Petersburg, Russia

2^nd Central European Congress of Rheumatology, 13-16 May, 1998, Warsaw, Poland 
published in Reumatologia 1998, Suppl Vol. XXXVI, Warsaw 1998, Lectures No. 211, pp 108-110 
ISSN 0034-6233

619 KA (19-09-2)

Frequent side effects of the basic medications demand the search for new therapeutic agents in the treatment of the patients with rheumatoid arthritis. For this purpose we included medications of systemic enzymotherapy (Wobenzym and Phlogenzym) in the complex treatment of RA, which possess the properties of both basic medications and symptomatic antiinflammatory agents.
156 patients with RA (53 males and 103 females) aged 18-69, suffering from the RA for 3 months to 29 years (at average 105 months) have been studied. RA of articular type was diagnosed in 28 cases and the disease of articular-visceral type - in 128 cases.
All patients underwent routine clinical (duration of stiffness in the morning, Ritchie and Lee indices etc.) and laboratory studies (erythrocyte sedimentation rate - ESR, circulating immune complexes - CIC, rheumatoid factor - RF, immunoglobulins etc.) In addition, levels of IL-1b and TNF-a in blood serum as well as interferon status (serum interferon (INF) concentration, stimulated production of INF-a and INF-g ) were determined in 36 cases with RA. The patients studied were divided into 2 groups: the first (65 patients) were given NSAID, methotrexate in the dosage of 7.5-10 mg/weekly, the second (91 patients) were given NSAID, methotrexate and Wobenzym in the dosage of 21 - 30 dragee daily depending upon the degree of disease activity. Supporting dosage of the medication was 15 dragee daily. Besides, 14 patients with RA of the 2-nd group with RA activity of the 3-rd degree were given Phlogenzym in the dosage of 2 tablets 3 times a day in the first 1.5-2 months and then Wobenzym in the dosage of 21 dragee a day. 35 patients have been taking systemic enzymotherapeutic medications for a year and more, 53 patients for 5-12 months, 18 patients - for 2-6 months.