New possibilities of basic
therapy in patients with rheumatoid arthritis on the basis of
systemic enzyme therapy.
Kovalenko V.M., Golovkov Y.Z. New
possibilities of basic therapy in patients with rheumatoid arthritis
on the basis of systemic enzyme therapy. Reumatologia 1998, Suppl
Vol. XXXVI, Warsaw 1998, Lectures No. 212, pp 110-111.
Ukrainian Center of Rheumatology, Kiev, Ukraine. 2nd Central
European Congress of Rheumatology, 13-16 May, 1998, Warsaw, Poland
Wobenzym (Mucos Pharma, Germany) and NSAIDs (Diclofenac-Sodium) were
used in the 2 years-treatment of 15 rheumatoid arthritis (RA)
patients, aged 20-55 years, all of them with III disease activity
grade, X-ray stage II (Wobenzym group). The average duration of the
disease was 1 to 10 years. 8 patients have been earlier treated by
different medication. However, this treatment was found ineffective
and further intake of this medication was, therefore,
stopped.Control group included 20 patients which received a gold
derivate Tauredon as a basic medication (intramuscularly, usual
administration scheme). Both groups were comparable by the age, sex,
and the main clinical and laboratory parameters.
At the beginning of the treatment corticosteroid hormones at the
dose of 60-120 mg were intravenously administered (3-6 injections)
to the patients in both groups with high grades of the disease
activity. Patients received Wobenzym at the dose of 7-10 tablets 3x
daily for 2-4 weeks and 150-200 mg of Diclofenac-Sodium daily at the
beginning of the treatment. When a clear disease activity decrease
was observed, the dose level of Diclofenac was reduced to 75-100 mg
a day, while that of Wobenzym to 5 tablets 3 times a day. After the
achievement of apparent clinical remission, patients continued a
supporting treatment by Wobenzym at the dose of 25-75 mg daily.
Widely used criteria of RA patient's clinical and laboratory state
were analyzed.
First clear signs of RA remission appeared in the first (Wobenzym)
group after 2-3 months in comparison to 3-4 months in control group.
By the 6th month of treatment the apparent clinical remission was
achieved in 80% of patients in Wobenzym group and in about 70% of
patients in control group. During second year of observation, an
exacerbation of the disease was seen in 2 patients. They were,
therefore, additionally treated with Methotrexate.
As evidenced by the data presented, Wobenzym can be successfully
used in the treatment of RA. Systemic enzyme therapy can be combined
with corticosteroids, cytostatic immunosuppressors, gold derivates,
and NSAIDs.