mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-5-103-107mrj-1207Research ArticleОБЗОРЫREVIEWSЛокальная и генерализованная потеря костной ткани при ревматоидном артритеLocal and generalized bone loss in rheumatoid arthritishttps://orcid.org/0000-0002-6076-4374КоваленкоП. С.KovalenkoP. S.

Полина Сергеевна Коваленко

115522, Москва, Каширское шоссе, 34А

Polina Sergeevna Kovalenko

34A, Kashirskoe Shosse, Moscow 115522

polina_dydykina@mail.ruhttps://orcid.org/0000-0001-6923-6060КолгановаН. И.KolganovaN. I.

117198, Москва, ул. Миклухо-Маклая, 6

6, Miklukho-Maklaya Street, Moscow 117198

https://orcid.org/0000-0002-2985-8831ДыдыкинаИ. С.DydykinaI. S.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

КожевниковаП. О.KozhevnikovaP. O.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-4503-7750БланкМ. Ю.BlankM. Yu.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГАОУ ВО «Российский университет дружбы народов»РоссияRUDN UniversityRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202119102021155103107Copyright © Коваленко П.С., Колганова Н.И., Дыдыкина И.С., Кожевникова П.О., Бланк М.Ю., 20212021Коваленко П.С., Колганова Н.И., Дыдыкина И.С., Кожевникова П.О., Бланк М.Ю.Kovalenko P.S., Kolganova N.I., Dydykina I.S., Kozhevnikova P.O., Blank M.Y.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/1207

Представлен обзор одномоментных и многолетних проспективных наблюдений, в которых изучались изменение минеральной плотности кости (МПК) у больных ревматоидным артритом (РА) и факторы, оказывающие на нее влияние. Отмечена взаимосвязь локальной потери кости (счета эрозий) с генерализованной потерей МПК. Указано, что существующие стратегии лечения РА направлены на подавление воспаления, а не на предотвращение резорбции костной ткани. Приведены доказательства того, что противовоспалительная терапия с использованием глюкокортикоидов, метотрексата, генно-инженерных биологических препаратов в комбинации с антирезорбтивными препаратами (бисфосфонатами и деносумабом) способствует предупреждению потери МПК и прогрессирования эрозий. Подчеркивается, что остеопороз при РА, относящийся к иммуноопосредованным вторичным остеопатиям, является одним из наиболее частых и серьезных осложнений РА, определяющих неблагоприятное течение и прогноз основного заболевания.

The article presents a review of cross-sectional studies and long-term prospective observations dedicated to changes in bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and factors influencing it. The relationship between local bone loss (erosion count) and generalized BMD loss was noted. It is indicated that existing RA treatment strategies are aimed at suppressing inflammation rather than preventing bone resorption. There is evidence that anti-inflammatory therapy using glucocorticoids, methotrexate, and biologic DMARDs in combination with antiresorptive drugs (bisphosphonates and denosumab) helps prevent BMD loss and the progression of erosions. It is emphasized that osteoporosis in RA, which belongs to the immune-mediated secondary osteopathies, is one of the most frequent and serious complications of RA, which determine the unfavorable course and prognosis of the underlying disease.

ревматоидный артритминеральная плотность костирезорбциярентгеновская денситометрияостеопорозкостные эрозиидинамика потери костной тканиrheumatoid arthritisbone mineral densityresorptionX-ray densitometryosteoporosisbone erosiondynamics of bone lossСтатья подготовлена в рамках научной темы «Коморбидные инфекции при ревматических заболеваниях и проблемы безопасности антиревматической терапии (АААА-А19-119021190148-3, 0514-2019-0005).The investigation has been conducted within scientific topic №AAAA-A19-119021190148-3, 0514-2019-0005 «Comorbid infections in rheumatic diseases and safety issues of antirheumatic therapy».ReferencesWegierska M, Dura M, Blumfield E, et al. Osteoporosis diagnostics in patients with rheumatoid arthritis. Reumatologia. 2016; 54(1):29-34. doi: 10.5114/reum.2016.58759.Epub 2016 Mar 24.Wegierska M, Dura M, Blumfield E, et al. Osteoporosis diagnostics in patients with rheumatoid arthritis. 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The authors declare that there are no conflicts of interest present.