Elena Komarova, Borys Rebrov


Aldosterone blocker – Spironolactone has anti-inflammatory, anti-proliferative and anti-oxidative effects, that is why pathogenetically it is expedient to use it in complex therapy of rheumatoid arthritis.

Material and methods: 46 patients with RA took 25-50 mg/day of Spironolactone during 12 months as an addition to standard therapy, the comparison group consisted of 47 patients that got only standard therapy, all the patients were fully examined prior and post the treatment.

Results: complex RA therapy leads to improved VAS, HAQ, the antioxidative potential index F; decreased blood concentrations of TNF-α, ICAM-1, FGF and VEGF in contrast to standard therapy. Complex therapy made reduced the DAS 28 more > 0.6.

Conclusions: applying of Spironolactone in complex therapy of rheumatoid arthritis contributes to more pronounced improvement in indices of articular syndrome and patient’s life quality, reduce of anti-inflammatory, anti-proliferative and angiogenic cytokines, and more effectively reduces the activity of the disease comparing to standard therapy.


Rheumatoid arthritis, Aldosterone, Spironolactone, Activity of disease.

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Bendtzen, K., Hansen, P.R., Rieneck, K. (2003). Spironolactone inhibits production of proinflammatory cytokines, including tumour necrosis factor-a and interferon-g, and has potential in the treatment of arthritis. Clinical and Experimental Immunology, 134, 151–158.

Delcayre, C., Swynghedauw B. (2002). Molecular mechanisms of myocardial remodelling. The role of aldosterone. Journal of Molecular and Cellular Cardiology, 34, 1577-1584.

Giatromanolaki, A., Sivridis, E., Maltezos, E., Athanassou, N., Papazoglou, D., Gatter, K. C., Harris, A. L. and Koukourakis, M. I. (2003). Upregulated hypoxia inducible factor-1α and -2α pathway in rheumatoid arthritis and osteoarthritis. Arthritis Research and Therapy, 5(4), 193-201.

Guidelines for the Management of Rheumatoid Arthritis: 2002 Update. Arthritis & Rheumatism, 46 (2), 328346.

Huber, L.C., Distler, O., Tarnerl, I., Gay, R.E., Gay, S., Pap, T. (2006). Synovial fibroblasts: key players in rheumatoid arthritis. Rheumatology, 45, 669–675.

Kalden, J.R., Schattenkirchner, M., Sörensen, H., Emery, P., Deighton, C., Rozman, B., Breedveld, F. (2003). The efficacy and safety of leflunomide in patients with active rheumatoid arthritis: A five-year followup study. Arthritis & Rheumatism, 48 (6), 151320.

Klimiuk, P.A., Sierakowski, S., Latosiewicz, R., Cylwik, J.P., Cylwik, B., Skowronski, J., Chwiecko, J. (2002). Soluble adhesion molecules (ICAM-1, VCAM-1, and E-selectin) and vascular endothelial growth factor (VEGF) in patients with distinct variants of rheumatoid synovitis. Annals Rheumatic Diseases, 61 (9), 804-809.

Malemud, C.J. (2007). Growth hormone, VEGF and FGF: involvement in rheumatoid arthritis. Clinica Chimica Acta, 375, 10-19.

Paleolog, E. (2004). Hypoxia: not merely a regulator of angiogenesis? Arthritis Research and Therapy, 6 (2), 75-77.

Romas, E., Gillespie, M.T., Martin, T.J. (2002). Involvement of RANK ligand and TNF-alpha in bone destruction in rheumatoid arthritis. Bone, 30, 340  346.

Rombouts, K., Wielant, A., Hellemans, K., Schuppan, D., Geerts, A. (2001). Influence of aldosterone on collagen synthesis and proliferation of rat cardiac fibroblasts. British Journal of Pharmacology, 134(1), 224–232.

Sugiyama, T., Yoshimoto, T., Hirono, Y., Suzuki, N., Sakurada, M., Tsuchiya, K., Minami, I., Iwashima, F., Sakai, H., Tateno, T., Sato, R., Hirata, Y. (2005). Aldosterone increases osteopontin gene expression in rat endothelial cells. Biochemical and Biophysical Research Communications, 336, 163-167.

Sønder, S.U., Mikkelsen, M., Rieneck, K., Hedegaard, C.J., Bendtzen, K. (2006). Effects of spironolactone on human blood mononuclear cells: mineralocorticoid receptor independent effects on gene expression and late apoptosis induction. British Journal of Pharmacology, 148 (1), 46–53.

DOI: http://dx.doi.org/10.12955/emhpj.v7i1.428


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