mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2019-3-45-50mrj-932Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSВозможна ли ремиссия при ювенильном идиопатическом артрите без применения генно-инженерных биологических препаратов?Can remission be in juvenile idiopathic arthritis without the use of biological agents?ВалиеваС. И.ValievaS. I.

Валиева Сания Ириковна.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А; 117997, Москва, ул. Островитянова, 1.

Sania Irikovna Valieva.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991; 21, Ostrovityanov St., Moscow 117997.

SValieva@morozdgkb.ruГлазыринаА. А.GlazyrinaA. A.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

КулешовН. Н.KuleshovN. N.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

ДзисМ. С.DzisM. S.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

КурбановаС. Х.KurbanovaS. Kh.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

СологубА. С.SologubA. S.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

КоробьянцЕ. А.KorobiyantsE. A.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

ЮсуповаВ. Т.YusupovaV. T.

119991, Москва, 4-й Добрынинский переулок, 1/9, стр. 1А.

1/9, Fourth Dobryninsky Lane, Build. 1A, Moscow 119991.

Морозовская детская городская клиническая больница Департамента здравоохранения города Москвы; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияMorozov City Children's Clinical Hospital, Moscow Healthcare Department; N.I. Pirogov Russian National Research Medical University, Ministry of Heath of RussiaRussian FederationМорозовская детская городская клиническая больница Департамента здравоохранения города МосквыРоссияMorozov City Children's Clinical Hospital, Moscow Healthcare DepartmentRussian Federation2019180920191334550Copyright © Валиева С.И., Глазырина А.А., Кулешов Н.Н., Дзис М.С., Курбанова С.Х., Сологуб А.С., Коробьянц Е.А., Юсупова В.Т., 20192019Валиева С.И., Глазырина А.А., Кулешов Н.Н., Дзис М.С., Курбанова С.Х., Сологуб А.С., Коробьянц Е.А., Юсупова В.Т.Valieva S.I., Glazyrina A.A., Kuleshov N.N., Dzis M.S., Kurbanova S.K., Sologub A.S., Korobiyants E.A., Yusupova V.T.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/932

Цель исследования — оценить эффективность и безопасность терапии метотрексатом (МТ) для подкожного (п/к) введения у пациентов с ювенильным идиопатическим артритом (ЮИА) без системных проявлений.

Пациенты и методы

Пациенты и методы. Представлены результаты проспективного исследования эффективности и безопасности МТ у 247пациентов в возрасте от 1 года до 17 лет с суставными вариантами ЮИА, а также частота показаний для назначения генно-инженерных биологических препаратов данной категории больных. У всех пациентов ЮИА протекал без системных проявлений: у 106 был олигоартикулярный суставной синдром, у 94 — полиартикулярный негативный по ревматоидному фактору (РФ), у 15 — полиартикулярный позитивный по РФ, у 20 — энтезитный, у 12 — псориатический артрит. Диагноз ЮИА устанавливали на основании критериев ILAR. Всем пациентам после верификации диагноза назначался МТ в виде п/к инъекций в дозе 15 мг/м2/нед. Результаты и обсуждение. После 3 мес терапии МТ 50 и 70% улучшение по критериям ACR^^SU было зарегистрировано у 65 и 53% пациентов соответственно. После 6, 9 и 12 мес терапии стадия неактивной болезни или ремиссия отмечалась у 44,5; 85 и 100% пациентов соответственно.

Выводы

Выводы. Парентеральное введение МТ способствует достижению ремиссии заболевания и восстановлению функции суставов у пациентов с ЮИА без внесуставных проявлений. Наряду с высокой терапевтической эффективностью МТ обладал хорошей переносимостью и благоприятным профилем безопасности.

Objective

Objective: to evaluate the efficiency and safety of therapy with subcutaneous (SC) methotrexate (MTX) in patients with juvenile idiopathic arthritis (JIA) without systemic manifestations.

Patients and methods

Patients and methods. The paper presents the results of a prospective study of the efficacy and safety of MTX in 247patients aged 1 to 17 years with articular variants of JIA, as well as the frequency of indications for prescribing biological agents for this category of patients. JIA occurred without systemic manifestations in all the patients, including 106 with oligoarticular articular JIA, 94 with rheumatoid factor (RF)-negative polyarticular JIA, 15 with RF-positive polyarticular JIA, 20 with enthesitis-related JIA, and 12 with psoriatic arthritis. JIA was diagnosed according to the ILAR criteria. After verification of the diagnosis, all the patients were prescribed SC injections of MTX at a dose of 15 mg/m2/week.

Results and discussion

Results and discussion. After 3 months of MTX therapy, 50 and 70% improvements according to the ACR pediatric criteria were registered in 65 and 53% of the patients, respectively. After 6, 9, and 12 months of therapy, the stage of inactive disease or remission was observed in 44.5, 85, and 100% of the patients, respectively.

Conclusion

Conclusion. Parenteral MTX administration contributes to the achievement of disease remission and the restoration of joint functions in patients with JIA without extra-articular manifestations. Along with its high therapeutic efficacy, MTX had a good tolerability and a favorable safety profile.

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