Difficulties of biological therapy in the patient with active rheumatoid arthritis and secondary renal amyloidosis: A report of clinical case
R. A. Osipyants,
M. Z. Kanevskaya,
N. L. Kozlovskaya,
K. A. Demyanova,
M. M. Saidova,
A. V. Bespalova,
T. Sh. Mirilashvili https://doi.org/10.47360/1995-4484-2021-225-228
Abstract
A clinical case of a patient with active rheumatoid arthritis (RA) resistant to standard basic therapy is presented, which served as the reason for the appointment of the target drug – Janus kinase, tofacitinib (Jaquinus) and then biological therapy using anti-IL6 receptor antibody tocilizumab (Actemra). This clinical example demonstrates the patient with the presence of several complications, both the course of the disease – amyloid nephropathy with the development of nephrotic syndrome (NS) as a manifestation of secondary amyloidosis with kidney damage, as well as basic therapy – the presence of comorbid infections with hospital pneumonia and infectious (septic) knee arthritis.
An additional contribution of NS to the development of infectious complications in patients with RA receiving immunosuppressive therapy is supposed. Current treatment options for resistant RA and the feasibility of early use of biologics before the development of irreversible complications, as well as the difficulties of therapy and the complications associated with immunosuppression are discussed. Preventive measures for immunization with the anti-pneumococcal vaccine and the need to correct hemostatic disorders in patients with RA and NS are important.
About the Authors
R. A. Osipyants
Peoples’ Friendship University of Russia (RUDN); City Clinical Hospital named after A.K. Eramishantsev
Russian Federation
Russian Federation
Rita A. Osipyants
117198, Moscow, Miklukho-Maklaya str., 6
129327, Moscow, Lenskaya str., 15
M. Z. Kanevskaya
City Clinical Hospital named after A.K. Eramishantsev; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)
Russian Federation
Russian Federation
Marina Z. Kanevskaya
129327, Russian Federation, Moscow, Lenskaya str., 15
119991, Russian Federation, Moscow, Trubetskaya str., 8, building 2
N. L. Kozlovskaya
Peoples’ Friendship University of Russia (RUDN); City Clinical Hospital named after A.K. Eramishantsev
Russian Federation
Russian Federation
Natalia L. Kozlovskaya
117198, Moscow, Miklukho-Maklaya str., 6
129327, Moscow, Lenskaya str., 15
K. A. Demyanova
Peoples’ Friendship University of Russia (RUDN); City Clinical Hospital named after A.K. Eramishantsev
Russian Federation
Russian Federation
Kseniya A. Demyanova
117198, Moscow, Miklukho-Maklaya str., 6
129327, Moscow, Lenskaya str., 15
M. M. Saidova
Peoples’ Friendship University of Russia (RUDN)
Russian Federation
Russian Federation
Maryam M. Saidova
117198, Moscow, Miklukho-Maklaya str., 6
A. V. Bespalova
City Clinical Hospital named after A.K. Eramishantsev
Russian Federation
Russian Federation
Anna V. Bespalova
129327, Moscow, Lenskaya str., 15
T. Sh. Mirilashvili
City Clinical Hospital named after A.K. Eramishantsev
Russian Federation
Russian Federation
Temuri Sh. Mirilashvili
129327, Moscow, Lenskaya str., 15
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Review
For citations:
Osipyants R.A., Kanevskaya M.Z., Kozlovskaya N.L., Demyanova K.A., Saidova M.M., Bespalova A.V., Mirilashvili T.Sh. Difficulties of biological therapy in the patient with active rheumatoid arthritis and secondary renal amyloidosis: A report of clinical case. Rheumatology Science and Practice. 2021;59(2):225-228. (In Russ.) https://doi.org/10.47360/1995-4484-2021-225-228
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