Добре дошли в сайта на д-р Севдалина Ламбова, дм, ревматолог





After establishing the diagnosis and detailed explanation to the patient the possible therapeutic approaches, the therapy that is mutually selected by the rheumatologist and the patient is started.


            The main treatments used in rheumatology are presented below:

            Nonsteroidal antiinflammatory drugs – the choice of medication depends on the individual risk and the concomitant pathology in the individual patient. Their administration standardly is accompanied by gastroprotectants for decreasing the risk of gastrointestinal complications.

            Corticosteroids – main medication class used in rheumatology. The treatment schedules, adverse effects as well as the approaches for avoidance of their development will be explained in details in our center.

            Intra-articular administration of corticosteroids and hyaluronic acid – the indications and contraindications for this treatment will be presented to your attention in our center. If necessary the injections will be performed under sonographic guidance.

            Antiosteoporotic drugs – oral and intravenous bisphosphonates, inhibitors of RANK-ligand (denosumab), strontium salts, alfacalcidol for treatment of osteoporosis and its complications. In every individual case, the appropriate therapeutic regiment will be chosen.


            Disease-modifying drugs in rheumatology:

                        Antimalarial drugs, salazopyrin

                        Cytotoxic drugs – methotrexate, cyclophosphamide, azathioprine, mycophenolate mofetil.

                        Biologic drugs – adalimumab, etanercept, golimumab, certolizumab, tocilizumab, etc.

                        In case of indications for treatment with the above-mentioned disease-modifying drugs, you will be screened for presence of contraindications for such treatment. You will receive instructions for the necessity of follow-up and for the potential adverse events in the course of treatment.


            Pulse-therapy with corticosteroids and cytotoxic drugs

            In a number of rheumatic diseases a regular therapy (for example monthly) with very high doses of corticosteroids and cytotoxic drugs is indicated (pulse therapy). In such cases you will be instructed for the possibility for preliminary preparation with the necessary investigations in order to shorten the hospital stay.