Метотрексат при ревматоидном артрите – 2015: новые факты и идеи
https://doi.org/10.14412/1995-4484-2015-421-433
Аннотация
За последнее десятилетие, с широким внедрением новых, эффективных генно-инженерных биологических препаратов (ГИБП), произошли серьезные изменения в стратегии лечения ревматоидного артрита (РА): в ее основу легла концепция «Treat to target» («Лечение до достижения цели»). Подчеркивается, что базовая составляющая стратегии – активная ранняя агрессивная терапия метотрексатом (МТ), а при недостаточной эффективности монотерапии МТ – комбинированная терапия МТ и стандартными базисными противовоспалительными препаратами или МТ и ГИБП. Хотя в рандомизированных плацебоконтролируемых исследованиях (РПКИ) и в клинической практике МТ чаще назначается перорально, в настоящее время наблюдается тенденция к более широкому использованию его подкожной формы. Новые данные, полученные в процессе фундаментальных исследований, касающихся расшифровки механизмов действия МТ, и материалы многочисленных РПКИ, наблюдательных исследований и национальных регистров обосновывают уникальное место МТ в лечении РА, его осложнений и сопутствующих коморбидных заболеваний. Целью обзора является анализ новых данных, касающихся механизмов действия и клинической эффективности и безопасности МТ в ревматологии.
Об авторе
Е. Л. Насонов
ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва, Россия 115522 Москва, Каширское шоссе, 34А
Россия
Россия
директор ФГБНУ НИИР им. В.А. Насоновой, академик РАН, докт. мед. наук, профессор
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Рецензия
Для цитирования:
Насонов Е.Л. Метотрексат при ревматоидном артрите – 2015: новые факты и идеи. Научно-практическая ревматология. 2015;53(4):421-433. https://doi.org/10.14412/1995-4484-2015-421-433
For citation:
Nasonov E.L. METHOTREXATE IN RHEUMATOID ARTHRITIS – 2015: NEW FACTS AND IDEAS. Rheumatology Science and Practice. 2015;53(4):421-433. (In Russ.) https://doi.org/10.14412/1995-4484-2015-421-433
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