References

rsp

Научно-практическая ревматология

Rheumatology Science and Practice

1995-44841995-4492

IMA-PRESS, LLC

10.14412/1995-4484-2018-99-106

rsp-2506

Research Article

ОБЗОРЫ

Стратегия снижения дозы и отмены генно-инженерных биологических препаратов при ревматоидном артрите в стадии ремиссии

STRATEGY FOR DOSE REDUCTION AND DISCONTINUATION OF BIOLOGICAL AGENTS IN RHEUMATOID ARTHRITIS REMISSION

Котовская

М. А.

Kotovskaya

M. A.

Москва.

Moscow.

Никишина

Н. Ю.

Nikishina

N. Yu.

Москва.

Moscow.

Олюнин

Ю. А.

Olyunin

Yu. A.

Москва.

Moscow.

olyunin@mail.ru

ФГБНУ «Научноисследовательский институт ревматологии им. В.А.Насоновой».РоссияV.A.Nasonova Research Institute of Rheumatology.Russian Federation

2018

04032018

56199106

2018

Котовская М.А., Никишина Н.Ю., Олюнин Ю.А.

Kotovskaya M.A., Nikishina N.Y., Olyunin Y.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://rsp.mediar-press.net/rsp/article/view/2506

Рекомендации по ведению больных ревматоидным артритом (РА) предусматривают усиление терапии при недостаточной ее эффективности; в то же время при успешном достижении поставленной цели может обсуждаться вопрос о снижении интенсивности лечения. В рекомендациях EULAR предусматривается возможность уменьшения дозы и даже отмены генно-инженерных биологических препаратов (ГИБП), особенно при проведении сочетанной терапии ГИБП и базисными противовоспалительными препаратами (БПВП). Однако стратегия такого изменения терапии еще недостаточно четко определена. В данном обзоре мы хотели бы затронуть вопрос, касающийся не раннего, а развернутого РА у больных с необратимыми изменениями опорно-двигательного аппарата, длительно получающих БПВП и/или ГИБП. При достижении ремиссии решить вопрос о возможности снижения дозы или отмены препарата в таких случаях бывает сложнее, чем при раннем РА.

Guidelines for the management of patients with rheumatoid arthritis (RA) envisage that its therapy should be intensified if it is insufficiently effective; at the same time, reduction of its intensity of treatment may be discussed when the set goal has been successfully achieved. The EULAR guidelines allow for dose reduction and even discontinuation of biological agents (BAs), especially when performing combination therapy with BAs and disease-modifying antirheumatic drugs (DMARDs). However, the strategy for this therapy change has not yet been sufficiently clearly defined. In this review, we would like to raise an issue regarding frank rather than early RA in patients with irreversible changes of the locomotor apparatus, who have received DMARDs and/or BAs for a long time. When remission is achieved, it is more difficult to reduce the dose of the drug or discontinue the latter in these cases than in early RA.

ревматоидный артритгенно-инженерные биологические препаратыбазисные противовоспалительные препаратылечениеремиссия

rheumatoid arthritisbiological agentsdisease-modifying antirheumatic drugstreatmentremission

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The authors declare that there are no conflicts of interest present.