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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1995-4484-2018-263-271</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-2558</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПЕРЕДОВАЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>FRONTIERS</subject></subj-group></article-categories><title-group><article-title>Ревматоидный артрит: проблемы ремиссии и резистентности к терапии</article-title><trans-title-group xml:lang="en"><trans-title>RHEUMATOID ARTHRITIS: THE PROBLEMS OF REMISSION AND THERAPY RESISTANCE</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Насонов</surname><given-names>Е. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Nasonov</surname><given-names>E. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А;</p><p>кафедра ревматологии Института профессионального образования, 119991, Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115552;</p><p>Department of Rheumatology, Institute of Professional Education, 8, Trubetskaya St., Build. 2, Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Олюнин</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Olyunin</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115552</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лила</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lila</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115552</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»;&#13;
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)<country>Россия</country></aff><aff xml:lang="en">V.A. Nasonova Research Institute of Rheumatology;&#13;
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»<country>Россия</country></aff><aff xml:lang="en">V.A. Nasonova Research Institute of Rheumatology<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>11</day><month>07</month><year>2018</year></pub-date><volume>56</volume><issue>3</issue><fpage>263</fpage><lpage>271</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Насонов Е.Л., Олюнин Ю.А., Лила А.М., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Насонов Е.Л., Олюнин Ю.А., Лила А.М.</copyright-holder><copyright-holder xml:lang="en">Nasonov E.L., Olyunin Y.A., Lila A.M.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/2558">https://rsp.mediar-press.net/rsp/article/view/2558</self-uri><abstract><p>Ревматоидный артрит (РА) – иммуновоспалительное (аутоиммунное) ревматическое заболевание неизвестной этиологии, характеризующееся хроническим эрозивным артритом и системным поражением внутренних органов, приводящее к ранней инвалидности и сокращению продолжительности жизни пациентов. Несмотря на достигнутые успехи в лечении РА, связанные с разработкой новых лекарственных препаратов и совершенствованием стратегии лечения, позволяющие добиться ремиссии у многих пациентов, остается много теоретических и клинических проблем, касающихся как определения понятия «ремиссия», ее характеристики и типов, так и подходов к оптимальной тактике «симптоматической» и «патогенетической» лекарственной терапии на разных стадиях болезни, применение которой позволит быстро индуцировать состояние ремиссии и поддерживать ее в долгосрочной перспективе. Необходимы дальнейшие исследования, направленные на изучение природы гетерогенности патогенетических механизмов РА и подходов к ранней диагностике, совершенствование методов мониторинга активности заболевания, биомаркеров эффективности и резистентности к терапии и, наконец, разработку дифференцированной терапии, в том числе связанной с поиском новых «терапевтических» мишеней.</p></abstract><trans-abstract xml:lang="en"><p>Rheumatoid arthritis (RA) is an immunoinflammatory (autoimmune) rheumatic disease of unknown etiology, which is characterized by chronic erosive arthritis and systemic visceral organ damage that results in early disability and shorter patient survival. Despite RA treatment advances associated with the design of novel drugs and the improvement of treatment strategies to achieve remission in many patients, there are still many theoretical and clinical problems concerning both the definition of the concept of remission, its characteristics and types and approaches to the optimum policy of symptomatic and pathogenetic drug therapy at different stages of the disease, the use of which will be able to rapidly induce and maintain remission in the long-term. Further investigations are needed to study the nature of heterogeneity of pathogenetic mechanisms of RA and approaches to early diagnosis, to improve methods for monitoring disease activity and biomarkers for the efficiency of and resistance to therapy and, finally, to develop differentiation therapy, including those related to a search for new therapeutic targets.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ревматоидный артрит</kwd><kwd>ремиссия</kwd><kwd>рефрактерность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>rheumatoid arthritis</kwd><kwd>remission</kwd><kwd>refractoriness</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов ЕЛ, Каратеев ДЕ, Балабанова РМ. Ревматоидный артрит. В кн.: Насонов ЕЛ, Насонова ВА, редакторы. Ревматология. Национальное руководство. Москва: ГЭОТАР-Медиа; 2008. С. 290-331 [Nasonov EL, Karateev DE, Balabanova RM. 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