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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mrj</journal-id><journal-title-group><journal-title xml:lang="ru">Современная ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Modern Rheumatology Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1996-7012</issn><issn pub-type="epub">2310-158X</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1996-7012-2018-4-65-70</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-864</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Ревматоидный артрит : проблемы лечения на современном этапе</article-title><trans-title-group xml:lang="en"><trans-title>Rheumatoid arthritis: problems of treatment at the present stage</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чичасова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chichasova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наталья Владимировна Чичасова.</p><p>119991, Москва, ул. Трубецкая, 8, стр. 2.</p><p>115522, Москва, Каширское шоссе, 34А.</p></bio><bio xml:lang="en"><p>Natalia Vladimirovna Chichasova.</p><p>8, Trubetskaya St., Build. 2, Moscow 119991.</p><p>34A, Kashirskoe Shosse, Moscow 115522.</p></bio><email xlink:type="simple">kafedrarheum@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кафедра ревматологии ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава России; ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой.</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Department of Rheumatology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; V.A. Nasonova Research Institute of Rheumatology.</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>07</day><month>12</month><year>2018</year></pub-date><volume>12</volume><issue>4</issue><fpage>65</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Чичасова Н.В., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Чичасова Н.В.</copyright-holder><copyright-holder xml:lang="en">Chichasova N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://mrj.ima-press.net/mrj/article/view/864">https://mrj.ima-press.net/mrj/article/view/864</self-uri><abstract><p>Сегодня существенно расширились возможности терапии ревматоидного артрита (РА). Помимо классических синтетических базисных противовоспалительных препаратов (сБПВП), генно-инженерных биологических препаратов (ГИБП) и таргетного синтетического БПВП (тсБПВП), в практику внедрена стратегия контролируемого лечения.</p><p>В статье продемонстрированы успехи раннего назначения сБПВП и проведения лечения по принципам treat to target – достижение цели через 6 мес у 50% больных при использовании подкожной формы метотрексата и у 45% при применении дженерика лефлуномида. На фоне такой терапии уменьшается потребность в ГИБП и тсБПВП.</p><p>В качестве первоочередных проблем обозначена необходимость обучения врачей общей практики методам раннего выявления РА и проведения школ для таких пациентов.</p></abstract><trans-abstract xml:lang="en"><p>The possibilities of rheumatoid arthritis therapy have been significantly expanded today. In addition to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic agents (BAs), and a targeted synthetic DMARD, a control treatment strategy has been put into practice.</p><p>The paper demonstrates successes in the early prescription of csDMARD and the implementation of treat-to-target principles – to achieve the goal after 6 months in 50% of patients receiving subcutaneous methotrexate and 45% of those using a Leflunomide generic. During this therapy, there is a lower need for BAs and targeted synthetic DMARDs. The priority problem is to train general practitioners in methods for the early detection of RA and to set up schools for these patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ревматоидный артрит</kwd><kwd>базисные противовоспалительные препараты</kwd><kwd>генно-инженерные биологические препараты</kwd><kwd>метотрексат</kwd><kwd>лефлуномид</kwd></kwd-group><kwd-group xml:lang="en"><kwd>rheumatoid arthritis</kwd><kwd>disease-modifying antirheumatic drugs</kwd><kwd>biologic drugs</kwd><kwd>methotrexate</kwd><kwd>leflunomide</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Насонова ВА, Фоломеева ОМ, Эрдес ШФ. Социальная значимость заболеваний ревматического круга в России. Научно-практическая ревматология. 2002;40(1):5-8. doi: 10.14412/1995-4484-2002-740</mixed-citation><mixed-citation xml:lang="en">Nasonova VA, Folomeeva OM, Erdes ShF. 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