НОВЫЕ НАПРАВЛЕНИЯ ЛЕЧЕНИЯ РЕВМАТОИДНОГО АРТРИТА: МЕХАНИЗМЫ ДЕЙСТВИЯ И КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ ЛЕФЛЮНОМИДА

1. <div><p>Балабанова Р.М, Ревматоидный артрит. В кн. '‘Ревматические болезни”. Под ред. В.А.Насоновой, Н.В. Бунчука. М., Медицина. 1997, 257-294.</p><p>Harris E.D. Rheumatoid arthritis. Palhophvsyology and implications for therapy. New Engl. J. Med. 1990, 322. 1277-1289.</p><p>Sewell, Trentham D. Pathogenesis of rheumatoid arthritis. Lancet. 1993. 341, 283-286.</p><p>Feldman М., Brennan F., Maini R.N. Role of cytokines in rheumatoid arthritis. Ann, Rev. Immunol,, 1996, 14, 397-440.</p><p>Насонов Е.Л, Противовоспалительная терапия ревматических болезней, 1999.</p><p>Slucki G., Langenegger T. Management of rheumatoid arthritis. Curr. Opin. Rheumatol., 1997, 9, 229-235.</p><p>Kwoh K.C., Simms R.W., Anderson L.G., et al. Guidelines for the management of rheumatoid arthritis. Arthr. Rheum., 1996,39,713-722.</p><p>Galindo-Rodriguez G., Avina-Zubieta J.A., Russel A.S., Suarez-Alamazor M.E. Disappointing longterm results with disease modifying antirheumatic drugs. A practical based study. J. Rheumatol., 1999, 26, 2337-2343.</p><p>Maetzel A., Wong A., Strand V., el al. Meta-analysis of treatment termonation rates among rheumatoid arthritis patients receiving disease-modifying anti-rheumatic druds. Rheumatol. 2000, 39, 975-981.</p><p>Wolfe F. The epidemiology of drug treatment failure in rheumatoid arthritis. (Review). Baillieres Clin. Rheumatol., 1995, 9,619-632.</p><p>Emery P, Salmon M. Early rheumatoid arthritis: time to aim for remission? Ann. Rheum. Dis., 1995, 54, 944-947.</p><p>Wolfe F, Hawley D.f, Cathey MA. Termination of slow acting anlirheumalic Lherapy in rheumatoid arthritis: a 14-year prospective evaluation of 1017 consecutive starts. J. Rheumatol., 1990, 17, 994-1002.</p><p>Felson DT, Anderson J J, Meenan RF. Use of short-term efficacy/toxicity tradeoffs to select second-line drugs in rheumatoid arthritis. A metaanalysis of published clinical trials. Arthr. Rheum., 1992,35, 1117-1125,</p><p>Silva H.T., Morris Jr.E. Leflunomide and malononi- triloamides Exp.Opin. Invest. Drugs, 1997, 6, 51-64</p><p>Breedveld F.C., Dayer J-M. Leflunomide: mode of action in the treatment of rheumatoid arthritis. Ann. Rheum, Dis., 2000, 59, 841-849.</p><p>Prakash A., Jarvis B. Leflunomide - a review of its use in active rheumatoid arthritis. Drugs, 1999, 58, 1137-1150,</p><p>Mladenovic V., Domljan Z., Rozman B., Jajic I. Mi- hajlovic D., Dordevic J., et al. Safety and effectiveness of leflunomide in the treatment of patients with active rheumatoid arthritis: results of a randomized, placebo-controlled, phase II study. Arthr. Rheum., 1995. 38, 1595— 1603.</p><p>Scott DL, Strand V. Leflunomide: a new immunosup- pres-sive drug. In: Strand V, Scott DL, Simon LS, eds. Novel therapeutic agents for the treatment of autoimmune diseases. New York: Marcel Dekker, 1997, 287293.</p><p>Herrmann ML, Schleyerback R, Kirschbaum BJ. Leflunomide, an immunomodulatory drug for the treatment of rheumatoid arthritis and other autoimmune disease. Immunopharmacol., 2000, 47, 273-289.</p><p>Bartlett RR, Schleyerbach R. Immunopharmacological profile of a novel isoxazol derivative, HWA 486, with potential antirheumaiic activity - I. Disease modifying action on adjuvant arthritis of the rat. Int. J. Immunop- hannacol., 19S5, 7, 7-18.</p><p>Pasternak RD, Wadopian NS. Wright RN, SiminofT P, Gylys JA, Buyniski JP. Disease modifying activity of HWA 486 in rat adjuvant-induced arthritis. Agents Actions, 1987.21.241-243.</p><p>Hambleton P. McMahon S. Drug actions on delayed-type hypersensitivity in rats with developing and established adjuvant arthritis. Agents Actions, 1990, 29. 328-332.</p><p>Bartlett RR. Immunopharmacological profile of HWA 486, a novel isoxazol derivative - 11. In vivo immuno- modulating effects differ from those of cyclophosphamide, prednisolone, or cyclosporin A. Int. J. Immunop- harmacol., 1986, 8, 199-204.</p><p>Kuo EA, Hambleton PT, Kay DP, Evans PL, Matharu SS, Little E, et al. Synthesis, structure - activity relationships, and pharmacokinetic properties of dihydrooro- tate-dehydrogenase inhibitors: 2-cyano-3-cyclopropyl- 3-hydroxy-N-[3'-methyl-4’-(trifluoromethyl)phenyl]- propenamide and related compounds. J. Med. Chem., 1996,39,4608^1621.</p><p>Miossec P. Are T cells in rheumatoid synovium aggressors or bystanders? Curr. Opin. Rheumatol., 2000, 12, 181-185.</p><p>Xu X, Blinder L, Shen J, Gong H, Finnegan A, Williams JW, el al. In vivo mechanism by which leflunomide controls Iymphoproliferative and autoimmune disease in MRL/MpJ-lpr/Ipr mice. J. Immunol., 1997.159,167-174.</p><p>Manna SK, Aggarwal BB. Immunosuppressive leflunomide metabolite (A77 1726) blocks TNF-dependent nuclear factor-кВ activation and gene expression. J. Immunol., 1999, 162,2095-2102.</p><p>Firenstein G.S., Manning A.M. Signal transduction and translation factor in rheumatic disease. Arthr. Rheum., 1999,42,609-621.</p><p>Kraan M.C., de Rooy H.H., Breedveld F.C., et al. The effects of leflunomide on cytokine production of human peripheral mononuclear cells. Ann. Eur, Congr. Rheumatol., Nice, 2000, 523.</p><p>Cao W, Kao P, Aoki Y., et al. A novel mechanism of action of the immunomodulatory drug, leflunomide: augmentation of the immunosuppressive cytokine, TGF- Ы, and suppression of the immunostimulatory cytokine, IL-2. Transplant. Proc., 1996, 28, 3079-3080.</p><p>Hamilton L., Vojnovic I., Bakhle Y., et al. The anti-inflammatory drug leflunomide inhibits in vitro and in vivo the activity of COX-2 more potently than the induction оГ COX-1 or iNOS. Br. J. Rheumatol., 1997, 120, 49</p><p>Deage V., Burger D., Dayer J-M. Exposure ofT lymphocytes to leflumonide but not to dexamethasone favors the production by monocytic cells of interleukin-l receptor antagonist and the lissue-inhibitor of metallo- proteinases-1 over that of interleukin-l в and metallo- proteinases. Eur. Cytokine New., 1998, 9, 663-668.</p><p>Kraan MC, de Koster B.M., Elferink J.G.R., et al. Inhibition of neutrophil mifration soon after initiation of treat- mernt with leflunomide or methotrwxate in patients with rheumatoid arthritis. Arthr. Rheum., 2000,43, 1488-1495.</p><p>Kraan M.C., Reece R.J., Barg F.C., et al. Expression of ICAM-1 and MMP-12 in rheumatoid synovial tissue after treatment with leflunomide or methotrexate. 63 Ann. Scient. Meet. Amer. Coll. Rheumatol., 1999, Boston.</p><p>Strand V, Cohen S. Schiff M, Weaver A, Fleischmann R, Cannon G, etal. Treatment of active rheumatoid arthritis with leflunomide compared to placebo and methotrexate. Arch. Intern. Med., 1999. 159, 2542-2550.</p><p>Smolen.IS, Kalden JR, Scott DL, Rozman B, Kvien TK, Loew-Friedrich I, e/ a. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multi-centre trial. Lancet, 1999, 353, 259-266.</p><p>Emery P, Breedveld FC, Lemmel EM, Kaltwasser JP, Dawes PT, Gunmr B, el al. A comparison of the efficacy and safety of leflunomide and methotrexate for the treatment of rheumatoid arthriLis. Rheumatol., 2000, 39, 655665.</p><p>Tugwell P., Wells G. Strand V., et al. Clinical improvement as reflected in measures of functional and health- related quality of life following treatmnt with leflunomide compared with methotrexate in patients with rheumatoid arthritis. Arthr. Rheum,, 2000, 43, 506-514.</p><p>Kremer JM. Methotrexate and leflunomide; biochemical basis for combination therapy in the treatment of rheumatoid arthritis. Semin, Arthr. Rheum., 1999, 29, 14-26.</p><p>Насонов Е.Л., Соловьев С.К. Применение метотрексата в ревматологии. М., 2000, 128.</p><p>Weinblatt М.Е., kremer J.М., Coblyn J.S. et al. Pharmacokinetics, safety, and efficacy of combination treatment with methotrexate and leflunomide in patients with active rheumatoid arthritis. Arthr. Rheum,, 1999,42, 13221328.</p><p>McChesney LP, Xiao F, Sankary HN, Foster PF, Shar- ma S. Haklin M, et al. An evaluation of leflunomide in the canine renal transplantation model. Transplant., 1994,57,1717-1722.</p><p>Waldman W.J., et al. Inhibition of CMV in vitro and in vivo by the experimental immunosuppressive agent leflunomide. Intervirol., 1999, 42, 412-418.</p></div><br />