mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-5-7-11mrj-1190Research ArticleЛЕКЦИИLECTURESТруднолечимый ревматоидный артрит. Какой он?Difficult-to-treat rheumatoid arthritis. What is it?https://orcid.org/0000-0001-9820-8851ГордеевА. В.GordeevA. V.

Андрей Викторович Гордеев

115522, Москва, Каширское шоссе, 34А

Andrey Viktorovich Gordeev

134A, Kashirskoe Shosse, Moscow 115522

avg1305@yandex.ruhttps://orcid.org/0000-0002-8665-7980ОлюнинЮ. А.OlyuninYu. A.

115522, Москва, Каширское шоссе, 34А

134A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-2776-4276ГалушкоЕ. А.GalushkoE. A.

115522, Москва, Каширское шоссе, 34А

134A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-4579-2836ЗоткинЕ. Г.ZotkinE. G.

115522, Москва, Каширское шоссе, 34А

134A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34А

125993, Москва, ул. Баррикадная, 2/1, стр. 1

134A, Kashirskoe Shosse, Moscow 115522

Barrikadnaya Street, Build. 1, Moscow 125993

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; Кафедра ревматологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; 34A, Kashirskoe Shosse, Moscow 115522, Russia; 22/1Russian Federation202118102021155711Copyright © Гордеев А.В., Олюнин Ю.А., Галушко Е.А., Зоткин Е.Г., Лила А.М., 20212021Гордеев А.В., Олюнин Ю.А., Галушко Е.А., Зоткин Е.Г., Лила А.М.Gordeev A.V., Olyunin Y.A., Galushko E.A., Zotkin E.G., Lila A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1190

Широкое внедрение в клиническую практику современных подходов к лечению ревматоидного артрита (РА), рациональное использование традиционных и таргетных противоревматических препаратов позволяют эффективно подавлять воспалительную активность, сдерживать прогрессирование болезни и улучшать качество жизни больных. Вместе с тем у части пациентов даже после повторной смены таргетных препаратов не удается добиться целевого уровня активности РА. Серьезные затруднения, возникающие при ведении таких пациентов, поставили вопрос о выделении особого варианта болезни – труднолечимого (difficult to treat, D2T) РА. Наличие разнообразных вариантов D2T РА и необходимость использования персонифицированного подхода к терапии обосновывают создание специальных рекомендаций по ведению данной категории больных. Первым шагом к подготовке данных рекомендаций стало определение понятия D2T РА, недавно представленное рабочей группой EULAR. Оно предусматривает соответствие пациента трем критериям: 1) недостаточная эффективность проводимой терапии; 2) наличие активного симптоматического заболевания; 3) клиническое восприятие.

The widespread introduction into clinical practice of modern approaches to the treatment of rheumatoid arthritis (RA), the rational use of traditional and targeted antirheumatic drugs can effectively suppress inflammatory activity, restrain the progression of the disease and improve the quality of life of patients. At the same time, in some patients, even after the repeated change of targeted drugs, it is not possible to achieve the target level of RA activity. Serious difficulties arising in the management of such patients raised the question of identifying a special variant of the disease – difficult-to-treat (D2T) RA. The presence of various variants of D2T RA and the need to use a personalized approach to therapy justify the creation of special recommendations for the management of this category of patients. The first step in preparing these recommendations was the definition of D2T RA recently presented by the EULAR working group. It includes three criteria: 1) insufficient effectiveness of the therapy; 2) the presence of an active symptomatic disease; 3) clinical perception.

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