Метотрексат в лечении ревматических заболеваний
https://doi.org/10.14412/1996-7012-2013-2438
Аннотация
Представлен обзор литературы, посвященной применению метотрексата (МТ) при ревматоидном артрите (РА) и других ревматических заболеваниях. Оценены эффективность и переносимость МТ, определяющие возможность рассматривать его в качестве «золотого стандарта» в лечении РА. Рассмотрены основные побочные реакции МТ, которые представлены в литературе и которые мы наблюдали в течение 28 лет применения МТ в терапии РА.
Об авторах
М. З. Каневская
Кафедра госпитальной терапии № 1 лечебного факультета ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва
Россия
Россия
С. В. Гурская
ГБУЗ «Городская клиническая больница № 20 ДЗ г. Москвы»
Россия
Россия
Литература
1. <div><p>Насонов ЕН, Каратеев ДЕ, Балабанова РМ. Ревматоидный артрит. В кн.: Ревматология. Национальное руководство. Под редакцией Е.Л. Насонова, В.А. Насоновой. Москва: ГЭОТАР-Медиа; 2008. С. 290–331. [Nasonov EN, Karateev DE, Balabanova RM. Revmatoidnyy artrit. V kn.: Revmatologiya. Natsional'noe rukovodstvo. Nasonova EL, Nasonovoy VA, editors. Moscow: GEOTAR-Media; 2008. P. 290–331.]</p><p>Smolen JS, Lamdeve R, Breedfeld FC et al. EULAR recommendations of rheumatoid arthritis with sinthetic and biological disease-modifyng anti-rheumatic drugs. Ann Rheum Dis. 2010;69(6):964–75. DOI: 10.1136/ard.2009.126532. Epub 2010 May 5.</p><p>Rasker JJ, Cosh JA. The natural history of rheumatoid arthritis: A fifteen year follow-up study. The prognostic significance of features noted in the first year. Clin Rheumatol. 1984;3(1):11–20. DOI: http://dx.doi.org/10.1007%2FBF02715690.</p><p>Wolfe F, Hawley DJ. Remission in rheumatoid arthritis. J Rheumatol. 1985;12; 245–52.</p><p>Ward JR. Historical perspective on the use of methotrexate for the treatment of rheumatoid arthritis. J Rheumatol. 1985;12 (Suppl 12):3–6.</p><p>Pincus T, Yazici Y, Sokka T et al. Methotrexate as the “ancor drug” for the treatment of early rheumatoid arthritis. Clin Exp Rheumatol. 2003;21 (5 Suppl 31):S179–85.</p><p>Rau R, Herborn G. Benefit and risk of methotrexate in rheumatoid arthritis. Clin Exp Rheumatol. 2004;22(5 Suppl 35):S83–94.</p><p>Kremer JM, Phelps CT. Long-term prospective study of the methotrexate in the treatment of rheumatoid arthritis: Update after a mean of 90 months. Arhtritis Rheum. 1992;35(2):138–45.</p><p>Weinblatt ME, Kaplan H, Germain BF, et al. Methotrexate in rheumatoid arthritis. A five-year prospective multicenter study. Arthritis Rheum. 1994;37(10):1492–8. DOI: http://dx.doi.org/10.1002%2Fart.1780371013.</p><p>Kremer JM. Safety, efficacy, and mortality in a long-term cohort of patients with rheumatoid arthritis taking methotrexate: Follow-up after a mean 13,3 years. Arhtritis Rheum. 1997;40(5):984–5.</p><p>Maravi M, Bologna C, Daures JP et al. Radiologic progression in early rheumatoid arthritis treated with methortexate: A prospective open long-term study of 191 cases. J Rheumatol. 1999;26(2):2622–267.</p><p>Wolfe F, Hawley DJ, Athey MA. Termination of slow acting anti-rheumatic therapy in rheumatoid arthritis: A 14-ye prospective evaluation of 1017 consecutive starts. J Rheumatol. 1990;17(8):994–1002.</p><p>Pincus T, Marcum SB, Callahan LF. Long-term drug therapy for rheumatoid arthritis in seven rheumatology private practices: II. Second-line drugs and prednisolone. J Rheumatol. 1992;19(12):1885–94.</p><p>Buchbinder R, Hall S, Sambrook PN et al. Methotrexate therapy in rheumatoid arthritis: A life table review of 587 patients treated in community practice. J Rheumatol. 1993;20(4):639–44.</p><p>Wluka A, Buchbinder R, Mylvagan MA et al. Long-term methotrexate use in rheumatoid arthritis: 12 year follow-up of of 460 patients treated in community practice. J Rheumatol. 2000;27(8):1864–71.</p><p>Choi HK, Seeger JD, Kuntz KM. A cost effectiveness analysis of treatment options for methotrexate-naïve rheumatoid arthritis. J Rheumatol. 2002;29(6):1156–65.</p><p>Krause D, Schleusser B, Herbon G, Rau R. Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis. Arthritis Rheum. 2000;43(1):14–21. DOI: http://dx.doi.org/10.1002%2F1529-0131%28200001%2943%3A1%3C14%3A%3AAID-ANR3%3E3.0.CO%3B2-7.</p><p>Chloi HK, Hernan MA, Seeger JD et al. Methotrexate and mortality in patients with rheumatoid arthritis. A prospective study. Lancet. 2002;359(9313):1173–7.</p><p>Kremer JM. Toward a better understanding of methotrexate. Arthritis Rheum. 2004;50(5):1370–82. DOI: http://dx.doi.org/10.1002%2Fart.20278.</p><p>Chan ES, Cronstein BN. Molecular action of methotrexate in inflammatory disease. Arthritis Res. 2002;4(4):266–73. Epub 2002 Mar 19.</p><p>Cronstein BN. Low-doses methotrexate: a mainstain in the treatment of rheumatoid arthritis. Pharmacology Rev. 2005;57(2):163–72. DOI: http://dx.doi.org/10.1124%2Fpr.57.2.3.</p><p>Miosses P, Briolay J, Dechanet J et al. Inhibition of the production of proinflomatory citokines and immunoglobulins by interleukin-4 in an ex vivo model of rheumatoid arthritis. Arthritis Rheum. 1992;35(8):874–83.</p><p>Seitz M, Zwiker M, Wider B. Enhanced in vitro induced production of interleukin-10 by peripheral blood mononuclear cells in rheumatoid arthritis is associated with clinical response to methotrexate treatment. J Rheumatol. 2001;28(3):496–501.</p><p>Gerards AH, de Lathouter S, de Groot ER et al. Inhibition of cytokine production by methotrexate. Studies in healthy volunteers and patients with rheumatoid arthritis. Rheumatology (Oxford). 2003;42(10):1189–96. Epub 2003 May 30.</p><p>Oguey D, Kolliker F, Gerber NJ, Reichen J. Effect of fod on the bioavalability of low-dose methortexate in patients with rheumatoid arthritis. Arthritis Rheum. 1992;35(6):611–4.</p><p>Kozlovski G, de Vito JM, Kisicki JC et al. The effect of food on the absorbtion of methotrexate sodium tablets in healthy volunteers. Arthritis Rheum. 1992;35:761–4.</p><p>Combe B, Kinowski JM, Bologna C et al. Effects of renal insufficiency on pharmacokinetics of methotrexate in rheumatoid arthritis. Arthritis Rheum. 1994;40 (Suppl):S94.</p><p>Bologna C, Endo L, Anaya JM et al. Methotrexate concentration in synovial membrane and trabecular and cortical bone in rheumatoid arthritis patients. Arthritis Rheum. 1994;37(12):1770–3. DOI: http://dx.doi.org/10.1002%2Fart.1780371210.</p><p>Practical prescribing guidelines in rheumatoid arthritis. Capel H, Madhok R, McInnes IB, editors. London&New York: Martin Dunitz; 2003. 214 p.</p><p>Alarcon GC, Tracy IC, Blackburn WD. Methotrexate in rheumatoid arthritis: toxic effects as the major factor in limiting longterm treatment. Arthritis Rheum. 1989;32(6):671–6.</p><p>Fehlauer CS, Carson CW, Cannon GW. Methotrexate therapy in rheumatoid arthritis: 2-year retrospective follow up study. J Rheumatol. 1989;16(3):307–12.</p><p>Насонов ЕЛ. Метотрексат. Перспективы применения в ревматологии. Москва, 2009. 196 с. [Nasonov EL. Metotreksat. Perspektivy primeneniya v revmatologii. Moscow, 2009. 196 s.]</p><p>Kremer JM, Lee RG. Liver histology in rheumatoid arthritis patients receiving long-term methotrexate therapy. A prospective study with baseline and sequential biopsy samples. Arthritis Rheum. 1989;32(2):121–7. DOI: http://dx.doi.org/10.1002%2Fanr.1780320202.</p><p>Hassan W. Methotrexate and liver toxicity: role of surveillance liver biopsy. Ann Rheum Dis. 1996;55(5):273–5. DOI: http://dx.doi.org/10.1136%2Fard.55.5.273.</p><p>White-O'Keefe QE, Fye KH, Sack CD. Methotrexate and histologic hepatic abnormalies: a meta-analysis. Am J Med. 1991;90(6):711–6.</p><p>Philips CA, Cera PJ, Mangan TF et al. Clinical liver disease in patients with RA taking methotrexate. J Rheumatol. 1992;19(2):229–33.</p><p>Kremer JM, Lee RG, Tolman KG. Liver histology in rheumatoid arthritis patients receiving long-term methotrexate therapy. A prospective study with baseline and sequential biopsy samples. Arthritis Rheum. 1989;32(2):121–7. DOI: http://dx.doi.org/10.1002%2Fanr.1780320202.</p><p>Shergy WJ, Polisson RP, Cadwell DS et al. Methotrexate associated hepatotoxicity: Retrospective analysis of 210 patients with RA. Am J Med. 1988;85(6):771–7.</p><p>Kremer JM, Galivan J, Streckfuss A, Kamen B. Methotrexate metabolism analysis in blood and liver of rheumatoid arthritis patients. Association with hepatic folate deficiency and formation of polyglutamates. Arthritis Rheum. 1986;29(7):832–35. DOI: http://dx.doi.org/10.1002%2Fart.1780290703.</p><p>Walker AM, Funch D, Dreyer NA et al. Determinants of serious liver disease among patients receiving low-dose methotrexate for rheumatoid arthritis. Arthritis Rheum. 1993;36(3):329–35. DOI: http://dx.doi.org/10.1002%2Fart.1780360307.</p><p>Kent PD, Luthra HS, Michet CJ. Risk factor for methotrexate-induced abnormal laboratory monitoring results on patients with rheumatoid arthritis. J Rheumatol. 2004;31(9):1727–31.</p><p>Langman G, Hall PM, Todd G. Role of alcogolic steatosis in methotrexate-induced liver iniury. J Gastroenterol Hepatol. 2001;16(12):1395–401.</p><p>Kujawska A, Clements M, Wise CM, Roberts WN. Hepatitis C and methotrexate. Arhritis Rheum. 2003;49(6):843–5. DOI: http://dx.doi.org/10.1002%2Fart.11451.</p><p>Al-Awadhil A, Dale P, McKendry RJ. Pancitopenia associated with low-dose methotrexate therapy. J Rheumatol. 1993;20(7):1121–5.</p><p>Gutierrez-Urena S, Molina JF, Garca CO et al. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum. 1996;39(2):272–6. DOI: http://dx.doi.org/10.1002%2Fart.1780390214.</p><p>Lim AY, Gafney K, Scott DG. Methotrexate-induced pancytopenis: serious and under-reported? Our experience of 25 cases in 5 yers. Rheumatology (Oxford). 2005;44(8):1051–5. Epub 2005 May 18.</p><p>Schwab UM, Moller JE, Zurborn KH et al. Increased incidence of methotrexate associated severe cytopenia in elderly patients. Arthritis Rheum. 1997;40 (Suppl):S54.</p><p>Duckley LM, Vacek PM, Cooper SM. Administration of folinic acid after low-dose methotrexate in patients with rheumatoid arthritis. J Rheumatol. 1990;17(9):1158–61.</p><p>Tanaka Y, Shiozava K, Nishbayashi Y, Imura S. Methotrexate-induced early onset pancitopenia in rheumatoid arthritis: drug allergy? Idiosyncrasy? J Rheumatol. 1992;19(8):1320–1.</p><p>Singh G, Fries JF, Williams CA et al. Toxicity profiles of disease modifying antirheumatic drugs in rheumatoid arthritis. J Rheumatol. 1994;18(2):243–52.</p><p>Van der Veen MJ, van der Heijde A, Kruize AA et al. Infections rate and use of antibiotics drugs in rheumatoid arthritis treated methotrexate. Ann Rheum Dis. 1994;53(4):224–8.</p><p>Gruberg L, Thaler M, Rozenman J et al. Nocardia asteroids infection complicating rheumatoid arthritis. J Rheumatol. 1991;18(3):459–61.</p><p>Antonelli MS, Moreland LW, Bricl JE. Herpes zoster in patients with RA treated with weekly, low-dose methotrexate. Am J Med. 1991;90(3):295–8.</p><p>Altz-Smith M, Kendal LG Jr, Stamm AM. Cryptococcus associated with low-dose methotrexate for arthritis. Am J Med. 1987;83(1):179–81.</p><p>Leff RL, Case JP, McKenzie R. Rheumatoid arthritis, methotrexate therapy and pneumacystic pneumonia. Ann Int Med. 1990;112(9):716.</p><p>Bogas M, Machado P, Mourao AF et al. Methotrexate treatment in rheumatoid arthritis: managemrnt in clinical remission, common infection and tuberculosis. Results from a systemic literature review. Clin Rheumatol. 2010;29(6):629–35.</p><p>Lloyd ME, Carr M, McElhatton P et al. The effects of methotrexate on pregnancy, fertility and lactation. QJM. 1999;92(10):551–63. DOI: http://dx.doi.org/10.1093%2Fqjmed%2F92.10.551.</p><p>Buckley LM, Bullaboy CA, Leochtman L et al. Multiple congenital abnormalities associated with weekly low-dose methotrexate treatment of the mother. Arthritis Rheum. 1997;43:201–15.</p><p>Avina-Zubieta JA, Choi HK, Sadatsafavi M et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta analysis of observational studies. Arhtritis Rheum. 2008;59(12):1690–7. DOI: doi: 10.1002/art.24092.</p><p>Choi HK, Herman MA, Seeger JD et al. Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet. 2002;359(9313):1173–7. DOI: http://dx.doi.org/10.1016%2FS0140-6736%2802%2908213-2.</p><p>Насонов EЛ. Лечение ревматоидного артрита 2012: место метотрексата. Научно-практическая ревматология. 2012;2 (приложение 1):1–24. [Nasonov EL. Lechenie revmatoidnogo artrita 2012: mesto metotreksata. Nauchno-prakticheskaya revmatologiya. 2012;2 (prilozhenie 1):1–24.]</p><p>Weslake SL, Imamura F, Wyler von Ballmoos M et al. The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systemiv literature review. Rheumatology (Oxford). 2010;49(2):295–307. DOI: 10.1093/rheumatology/kep366. Epub 2009 Nov 27.</p><p>Halla JT, Hardin JG. Under-recognized post-dosing reactions to methotrexate in patients with rheumatoid arthritis. J Rheumatol. 1994;21(7):1224–6.</p><p>Slot O. Changes in plasma homocysteine in arthritis patients starting treatment with low-dose methotrexate subsequently supplemented with folic acid. Scand J Rheumatol. 2001;30(5):305–7. DOI: http://dx.doi.org/10.1080%2F030097401753180408.</p><p>Patatanian E, Thompson DF. A review of methotrexate-induced accelerated nodulosis. Pharmacotherapy. 2002;22(9):1157–62. DOI: http://dx.doi.org/10.1592%2Fphco.22.13.1157.33525.</p><p>Marguerie L, Flipo RM, Grardel B et al. Use of disease-modifying antirheumatic drugs in patients with psoriatic arthritis. Joint Bone Spine. 2002;69(3):275–81. DOI: http://dx.doi.org/10.1016%2FS1297-319X%2802%2900396-2.</p><p>Бадокин ВВ. Эффективность и переносимость метотрексата при псориатическом артрите. Фарматека. 2012;19(252):45–51. [Badokin VV. Effektivnost' i perenosimost' metotreksata pri psoriaticheskom artrite. Farmateka. 2012;19(252):45–51.]</p><p>Abu-Shacra M, Gladman DD, Thorne JC et al. Long-term methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. J Rheumatol. 1995;22(2):241–5.</p><p>Whiting-O'Keefe QE, Fye KH, Sack KD. Methotrexate and histologic hepatic abnormalities: a meta-analysis. Am J Med. 1991;90:711–6. DOI: http://dx.doi.org/10.1016%2F0002-9343%2891%2990667-M.</p><p>Salaffi F, Mangenelli P, Carotti M et al. Methotrexate-induced pneumonitis in patients with rheumatoid arthritis and psoriatic arthritis: report of five cases and review of the literature. Clin Rheumatol. 1997;16(3):296–304. DOI: http://dx.doi.org/10.1007%2FBF02238967.</p><p>Aydintung AO, D’Cruz D, Cervera R et al. Low-dose methotrexate treatment in adult Still's disease. J Rheumatol. 1992;19(3):431–5.</p><p>Kraus A, Alarcon-Segovia D. Fever in adult onset Still's disease. Response to methotrexate. J Rheumatol. 1991;18(6):918–20.</p><p>Oddis CV. Current approach to the treatment of polymyositis and dermatopolymyositis. Curr Opin Rheumatol. 2000;12(6):492–7.</p><p>Van der Veen MJ, Dinant HJ, van Booma-Francfort C et al. Can methotrexate be used as a steroid sparing agent in the treatment of polymyalgia rheumatic and giant cell arteritis. Ann Rheum Dis. 1996;55(4):218–23.</p><p>Jover JA, Hernandez-Garnandez-Garsia C, Morado IC et al. Combined treatment of giant-cell arteriitis with methotrexate and prednisolon: a randomized, double-blind, placebo controlled tral. Ann Intern Med. 2004;143:493–500.</p><p>Hoekstra M, Haagsma C, Neef C et al. Bioavailability of high dose methotrexate comparing oral and subcutaneous administration in patients with rheumatoid arthritis. J Rheumatol. 2004;31:645–8.</p><p>Stamp LK, Barclay ML, O’Donnell JL et al. Effects of changing from oral to subcutaneous methotrexate on red blood cell methotrexate polyglutamate concentrations and disease activity in patients with rheumatoid arthritis. J Rheumatol. 2011;38(12):2540–7. DOI: http://dx.doi.org/10.3899%2Fjrheum.110481.</p><p>Moitra RK, Leginham JM, Hull RG et al. Caveats to the use of parental methotrexate in the treatment of rheumatic disease. Rheumatology (Oxford). 2005;44(2):256–7. Epub 2005 Jan 5.</p><p>Муравьев ЮВ, Денисов ЛН, Алексеева ЛИ и др. Открытое контролируемое рандомизироанное 24-недельное сравнительное исследование инъекционной и таблетированной лекарственных форм метотрексата при ревматоидном артрите. Научно-практическая ревматология. 2011;5:58–61. [Murav'ev YuV, Denisov LN, Alekseeva LI i dr. Otkrytoe kontroliruemoe randomiziroannoe 24-nedel'noe sravnitel'noe issledovanie in"ektsionnoy i tabletirovannoy lekarstvennykh form metotreksata pri revmatoidnom artrite. Nauchno-prakticheskaya revmatologiya. 2011;5:58–61.]</p><p>Bosello S, Fedele AL, Peluso G et al. Very early rheumatoid arthritis is the major predictor of major outcome: clinical ACR remission and radiographic non-progression. Ann Rheum Dis. 2011;70(7):1292–5. DOI: http://dx.doi.org/10.1136%2Fard.2010.142729.</p></div><br />
Рецензия
Для цитирования:
Каневская МЗ, Гурская СВ. Метотрексат в лечении ревматических заболеваний. Современная ревматология. 2013;7(4):47-53. https://doi.org/10.14412/1996-7012-2013-2438
For citation:
Kanevskaya MZ, Gurskaya SV. Methotrexate in the treatment of rheumatic disease. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2013;7(4):47-53. (In Russ.) https://doi.org/10.14412/1996-7012-2013-2438
Просмотров:
2856
Послать статью по эл. почте 