Лечение ревматической полимиалгии

При лечении ревматической полимиалгии (РП) средством выбора являются глюкокортикоиды (ГК), которые дают хороший и быстрый клинический эффект. Представлен обзор англоязычных публикаций, посвященные вопросам лечения РП. Проанализировано 30 исследований (13 рандомизированных и 17 наблюдательных), включающих 20 и более пациентов с РП. Особое внимание уделено начальной терапии ГК, оценке их различных суточных доз, схемами снижения дозы и завершения лечения ГК, а также частоте рецидивов. Рассмотрены исследования, посвященные лечению преднизоном, преднизолоном, метипреднизолоном, дефлазакортом, инъекционными пролонгированными формами ГК. Проанализированы данные клинических испытаний глюкокортикоид-сберегающих агентов (метотрексат, азатиоприн) в периоды начала терапии и поддерживающей терапии. В качестве альтернативы рассмотрены изучавшиеся в клинических испытаниях генно-инженерные биологические препараты (инфликсимаб, этанерцепт); описан случай использования ритуксимаба. Оценивается также роль нестероидных противовоспалительных препаратов в лечении РП. Представлен алгоритм ведения больного РП.

ревматическая полимиалгия, глюкокортикоиды, преднизон, преднизолон, метилпреднизолон, дефлазакорт, метотрексат, азатиоприн, нестероидные противовоспалительные препараты, биологическая терапия

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