Artur Bachta

Publications of Artur Bachta

• [Pharmacological treatment of recurrent idiopathic anterior uveitis].

  Authors: Jerzy Szaflik, Artur Bachta, Maciej Kulig, Mateusz Tłustochowicz, Andrzej Stankiewicz, Witold Tłustochowicz

  Klinika oczna. 01/2011; 113(4-6):111-6.

  Recurrent anterior uveitis (AU) is an autoimmune disease that in 20% of patients leads to severe visual loss or blindness, thereby a severe disability and significant quality of life impairment. ThatRecurrent anterior uveitis (AU) is an autoimmune disease that in 20% of patients leads to severe visual loss or blindness, thereby a severe disability and significant quality of life impairment. That is why, it is important to conduct a long term treatment after an acute phase of the disease, to keep the remission as long as possible. Up to 50% of patients with recurrent AU have no additional symptoms of systemic disease. This situation, classified as idiopathic AU (IAU), causes a lot of problems when a therapeutic strategy has to be chosen. Nevertheless, IAU is considered to be a first symptom of spondylarthropathy (SpA), even several dozen years prior to other typical manifestations of SpA. There have been published few papers concerning only small groups of patients with IAU, treated with disease modifying anti-rheumatic drugs. The authors present the recommendations for systemic treatment of IAU, based on their own clinical experience, and systematic review of the literature.

• [Leflunomide as a second choice treatment in patients with rheumatoid arthritis]

  Authors: Anna Raczkiewicz-Papierska, Anna Dudek, Artur Bachta, Małgorzata Tłustochowicz, Beata Zawadyl, Marian Sułek

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 06/2007; 22(132):547-50.

  Leflunomide is a relatively new disease modifying antirheumatic drug (DMARD) and a number of studies evaluating its effectiveness and safety in daily medical practice is limited. THE AIM OF THELeflunomide is a relatively new disease modifying antirheumatic drug (DMARD) and a number of studies evaluating its effectiveness and safety in daily medical practice is limited. THE AIM OF THE STUDY: Evaluation of effectiveness and safety of leflunomide treatment in patients with active rheumatoid arthritis in whom methotrexate was ineffective or contraindicated. MATERIAL AND METHODS: Eighty one patients (66 women and 15 men) with RA diagnosed according to ARA (The American Rheumatism Association) criteria were included in the study. The mean age was 57.6+/-11.7 years and the mean disease duration was 7.7+/-7.1 years. The inclusion criteria were: disease activity according to DAS28 (Disease Activity Score)>3.2 and contraindications to methotrexate or ineffective methotrexate treatment for at least 3 months. At the beginning of the study 49 of patients were treated with methotrexate in weekly dose of 17+4.2mg and 32 were not treated with DMARDs. Oral glicocorticosteroids in stable doses of 5-15mg of prednisone were given to 66 (77.7%) of them. There was no statistically significant difference in radiological progression of the disease according to Steinbrocker's scale between groups (treated and not treated with methotrexate). Monotherapy with leflunomide was started with loading dose of 100mg for 3 days, and then 20mg daily. Combination therapy was introduced without loading dose. Evaluation was performed monthly and included: duration of morning stiffness, pain and disease activity according to VAS (visual-analogue) scale, the number of tender and swollen joints, blood count, ESR, CRP, aminotransferases activity, and the presence and intensity of adverse reactions. The results of treatment were evaluated after 5 months in 37 of patients and adverse reactions which happened until the end of 5th month were evaluated in all included patients. RESULTS: The mean DAS28 values improved exponentially during consecutive months and the difference between them was statistically significant. Adverse reactions during 5 months of treatment were observed in 36(44,4%) of patients and in 6(7,4%) of cases the treatment had to be stopped because of side effects. The frequency of adverse reactions was similar in monotherapy and combination therapy group. CONCLUSIONS: Leflunomide therapy can be effective in patients with active rheumatoid arthritis in whom methotrexate is contraindicated or insufficient. Combination of leflunomide with methotrexate is safe and does not increase the frequency of adverse reactions.

• [Prevalence of cervical spine inflammatory changes in rheumatoid arthritis patients and the value of neurological examination in their diagnosis]

  Authors: Anna Raczkiewicz-Papierska, Artur Bachta, Ewa Nagańska, Magdalena Zagrodzka, Ewa Skrobowska, Małgorzata Tłustochowicz, Anna Dudek, Witold Tłustochowicz

  Polskie archiwum medycyny wewnȩtrznej. 11/2006; 116(4):938-46.

  The aim of the study was to evaluate prevalence of cervical spine inflammatory changes, especially atlantoaxial pathology, and their possible relation to subjective and objective neurologicalThe aim of the study was to evaluate prevalence of cervical spine inflammatory changes, especially atlantoaxial pathology, and their possible relation to subjective and objective neurological symptoms in rheumatoid arthritis patients. 100 patients (88 female and 12 male) aged 23 to 85 (61.4 +/- 12.9), with the mean disease duration of 12.5 +/- 9.5 years were included in the study. According to radiological examination (lateral and antero-posterior X-ray of the cervical spine) supplemented by MR of the cervical spine or CT of the atlanto-axial joint in suspected cases, 26% of patients had only inflammation, next 15% of patients presented with instability of the atlanto-axial joint and 9% developed basilar invagination of the dens of axis. 18% of patients presented subaxial cervical instability. Neurological examitation was performed by independent neurologist in 99 patients, only 14 presented abnormalities suggesting cervical myelopathy. Two of them showed no patology of the cervical spine. Remaining patients presented: C1/C2 inflammation in 4 cases, anterior atlanto-axial subluxation (AAS) in two cases, basilar invagination in 4 cases and instability with medullary compression on lower cervical levels only--in two cases. There were 4 cases of coexisting C1/C2 changes with medullary compression due to discopathy and (in 3 of them) instability on lower cervical levels. In 6 cases surgical stabilisation was proposed (5 patients with basilar invagination and 1 patient with AAS and myelopathy). There was statistically significant correlation between symptoms (like: paraesthesiae, intermittent problems with hearing and seeing), neurological examination and degree of radiological damage of atlanto-axial joint. The authors concluded that careful medical history and neurological examination can be useful in making decision of further radiological diagnostic procedures of the cervical spine in rheumatoid arthritis.

• [Systemic management of autoimmune anterior uveitis]

  Authors: Artur Bachta, Mateusz Tłustochowicz

  Klinika oczna. 02/2005; 107(10-12):710-4.

  Autoimmune uveitis is an acute, recurrent, sight-threatening disease that can lead to severe visual loss and blindness. It requires systemic immunosuppressive therapy and continuous monitoring byAutoimmune uveitis is an acute, recurrent, sight-threatening disease that can lead to severe visual loss and blindness. It requires systemic immunosuppressive therapy and continuous monitoring by ophthalmologist and rheumatologist. There are no universally accepted referral patterns for the treatment of endogenous uveitis. Most specialists indicate corticosteroids, methotrexate and cyclosporine A as the first use drugs. Anti-cytokine drugs are a new opportunity for the patients unresponsive to the conventional anti-inflammatory and immunosuppressive therapy.