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Современная ревматология

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Рекомендации EULAR по лечению ревматоидного артрита (2013): использование глюкокортикоидов

https://doi.org/10.14412/1996-7012-2014-2-28-34

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Аннотация

В статье обсуждается место глюкокортикоидов (ГК) в современной стратегии лечения ревматоидного артрита (РА) согласно рекомендациям EULAR 2013 г. Приведен обзор основных исследований ГК за весь период применения этих препаратов в лечении РА. Обсуждаются сложности, позитивные и негативные стороны использования ГК при РА, возможности их влияния на прогрессирование деструкции в мелких суставах кистей и стоп.

В связи с получением в последние годы новых данных рекомендация EULAR 2013 г. по ведению больных РА в отношении ГК сформулирована следующим образом: «В качестве компонента стратегии лечения в течение первых 6 мес болезни следует рассматривать применение низких доз ГК (в комбинации с одним или несколькими базисными противовоспалительными препаратами)». Особо подчеркивается, что ГК следует отменить как можно быстрее, насколько это возможно с клинической точки зрения. Термин «низкая доза ГК» подразумевает назначение преднизолона в дозе ≤7,5 мг/сут. 

Об авторе

Н.В. Чичасова
ФГБУ «Научно-исследовательский институт ревматологии им. В.А.Насоновой» РАМН, Москва, Россия
Россия


Литература

1. Conn DL. Resolved: low-dose prednisone is indicated as a standard treatment in patients with rheumatoid arthritis. Arthritis Rheum. 2001;45(5):462–7. DOI: http://dx.doi.org/10.1002/1529-0131(200110)45:5%3C462::AID-ART366%3E3.0.CO;2-V.

2. Saag KG. Resolved: low-dose glucocorticoids are neither safe nor effective for longterm treatment of rheumatoid arthritis. Arthritis Rheum. 2001;45(5):468–71. DOI: http://dx.doi.org/10.1002/1529-0131(200110)45:5%3C468::AID-ART367%3E3.0.CO;2-A.

3. Moreland LW, O’Dell JR. Glucocorticoids and rheumatoid arthritis. Back to the future? Arthritis Rheum. 2002;46(10):2553–63. DOI: http://dx.doi.org/10.1002/art.10567.

4. Conn DL, Lim SS. New role for an old friend; prednisone is a disease-modifying agent in early rheumatoid arthritis. Curr Opin Rheumatol. 2003;15(3):193–8. DOI: http://dx.doi.org/10.1097/00002281-200305000-00004.

5. Насонов ЕЛ. Лечение ревматоидного артрита: роль глюкокортикоидов. Клиническая медицина. 1999;4:4–8. [Nasonov EL. Lechenie revmatoidnogo artrita: rol' glyukokortikoidov. Klinicheskaya meditsina. 1999;4:4–8. (In Russ.)]

6. Pincus T, Sakka T, Stein CM. Are longterm very low doses of prednisolon for patients with rheumatoid arthritis as helpful as high doses are harmful? Ann Intern Med. 2002;136(1):76–8. DOI: http://dx.doi.org/10.7326/0003-4819-136-1-200201010-00013.

7. Bijsma JW, Boers M, Saag KG, Furst DE. Glucocorticoids in the treatment of early and late RA. Ann Rheun Dis. 2003;62(11):1033–7. DOI: http://dx.doi.org/10.1136/ard.62.11.1033.

8. Hench PS, Kendall EC, Slocumb CH, Polley HF. The effect of a hormone of the adrenal cortex (17-hydroxy-11-dehydrocortisone; compound E) and the pituitary adrenocorticotropic hormone on rheumatoid arthritis. Proc Staff Meet Mayo Clin. 1949;24:181.

9. Report by the Joint Committee of the Medical Research Council an Nuffield Foundation on Clinical Trials of cortisone? ACTH/ and other therapeutic measures in chronic rheumatic diseases. A comparison of prednisolone with aspirin or other analgesics in the treatment of rheumatoid arthritis [first report]. Ann Rheum Dis. 1959;18:173–87. DOI: http://dx.doi.org/10.1136/ard.18.3.173.

10. Report by the Joint Committee of the Medical Research Council an Nuffield Foundation on Clinical Trials of cortisone? ACTH/ and other therapeutic measures in chronic rheumatic diseases. A comparison of prednisolone with aspirin or other analgesics in the treatment of rheumatoid arthritis [second report]. Ann Rheum Dis. 1960;19:331–7. DOI: http://dx.doi.org/10.1136/ard.19.4.331.

11. Bollet AJ, Black R, Bunim JJ. Major undesirable effects resulting from prednisolone and prednisone. J Am Med Assoc. 1955;158(6):459–63. DOI: http://dx.doi.org/10.1001/jama.1955.0296006 0017005.

12. Saag KG, Criswell LA, Sems KM, et al. Low-dose corticosteroids in rheumatoid arthritis: a meta-analysis of their moderateterm effectiveness. Arthritis Rheum. 1996;39(11):1818–25. DOI: http://dx.doi.org/10.1002/art.1780391107.

13. Wolfe F, Mitchell DM, Sibley JT, et al. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994;37(4):2529–33. DOI: http://dx.doi.org/10.1002/art.1780370408.

14. Van Gestel AM, Laan RF, Haagsma CJ, et al. Oral steroids as bridge therapy in rheumatoid arthritis patients starting with parenteral gold: a randomized double-blind placebo-controlled trial. Br J Rheumatol. 1995;34(4):347–51. DOI: http://dx.doi.org/10.1093/rheumatology/34.4.347.

15. Pincus T, Marcum SB, Callahan LF. Long-term drug therapy in rheumatoid arthritis in seven rheumatology ptivat practice: II. Second line drugs and prednisolone. J Rheumatol. 1992;19(12):1885–94.

16. Caplan L, Russell AS, Wolfe F. Steroids for rheumatoid arthritis: the Honeymoon revisited (once again). Editorial. J Rhematol. 2005;32(10):1863–5.

17. Gotzsche PC, Johansen HK. Meta-analysis of short-term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis. BMJ. 1998;316(7134):811–8. DOI: http://dx.doi.org/10.1136/bmj.316.7134.811.

18. Criswell LA, Saag KG, Sems KM, et al. Moderate-term, low-dose corticosteroids for rheumatoid arthritis (Cochrane Review). In: The Cochrane Library, Issue 2. Chichester, UK: John Wiley & Sons, Ltd.; 2004.

19. Gorter SL, Bijlsma H, Cutolo M, et al. Current evidence for the management of rheumatoid arthritis with glucocorticoids:

20. a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2010;69(6):1010–4. DOI: 10.1136/ard.2009.127332. Epub 2010 May 6.

21. Smolen J, Landewe R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010;69(6):964–75. DOI: 10.1136/ard.2009.126532. Epub 2010 May 5.

22. Van Everdingen AA, Jacobs JW, Siewertsz van Reesema DR, et al. Low-dose prednosone therapy for patients with early active rheumatoid arthritis: clinical efficacy, diseasemodifying properties, and side effects: a randomized, double-blind, placebo-controlled clinical trial. Ann Intern Med. 2002;136:1–12. DOI: http://dx.doi.org/10.7326/0003-4819-136-1-200201010-00006,

23. Kirwan JR, Bijlsma JW, Boers M, et al. Effects of glucocorticoids on radiological progression in rheumatoid arthritis. Cochrane Database Syst Rev. 2007;(1):CD006356.

24. Smolen JS, Landewe R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73(3):492–509. DOI: 10.1136/annrheumdis-2013-204573. Epub 2013 Oct 25.

25. Buttgereit F, da Silva JA, Boers M, et al. Standartised nomenclature for glucocorticoids dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology. Ann Rheum Dis. 2002;61(8):718–22. DOI: http://dx.doi.org/10.1136/ard.61.8.718.

26. Gaujoux-Viala C, Nam JL, Ramiro S, et al. Efficacy of conventional synthetic disease-modifying antirheumatic drugs, glucocorticoids and tofacitinib — a systematic literature review informing the 2013 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis. 2014;73(3):510–5. DOI: 10.1136/annrheumdis-2013-204577. Epub 2014 Jan 7.

27. Bakker MF, Jacobs JW, Welsing PM, et al. Low-dose prednisone inclusion in a methotrexate-based, tight control strategy for early rheumatoid arthritis: a randomized trial. Ann Intern Med. 2012;156(5):329–39. DOI: 10.7326/0003-4819-156-5-201203060-00004.

28. Swensson B, Boonen A, Albertsson K, et al. Low-dose prednisolone in addition to the initial disease-modifying drug in patients with early active rheumatoid arthritis reduces joint destruction and increase the remission rate: a two-year andomized trial. Arthritis Rheum. 2005;52(11):3360–70. DOI: http://dx.doi.org/10.1002/art.21298.

29. Landewe RB, Boers M, Verhoeven AC, et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum. 2002;46(2):347–56. DOI: http://dx.doi.org/10.1002/art.10083.

30. Wassenberg S, Rau R, Steinfeld P, et al. Very low-dose prednisolone in early rheumatoid arthritis etard radiographic progression over two years: a multicenter, double-blind, placebo-controlled trial. Arthritis Rheum. 2005;52(11):3371–3380. DOI: http://dx.doi.org/10.1002/art.21421.

31. Goekoop-Ruiterman YP, De Vries-Bouwstra JK, Allaart CF, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BEST study): a randomized, controlled trial. Arthritis Rheum. 2005;52(11):3381–90. DOI: http://dx.doi.org/10.1002/art.21405.

32. Heimans L, Wevers-de Boer KV, Visser K, et al. A two-step treatment strategy trial in patients with early arthritis aimed at achieving remission: the IMPROVED study. Ann Rheum Dis. 2013 May 28. [Epub ahead of print]. DOI: 10.1136/annrheumdis-20130203243.

33. De Silva JA, Jacobs JW, Kirwan JR, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence trial data. Ann Rheum Dis. 2006;65(3):285–93.DOI: http://dx.doi.org/10.1136/ard.2005.038638. Epub 2005 Aug 17.

34. Hoes JN, Jacobs JW, Boers M, et al. EULAR evidence-based recommendations on the management of systemic glucocorticoids therapy in rheumatic diseases. Ann Rheum Dis. 2007;66(12):1560–7. DOI: http://dx.doi.org/10.1136/ard.2007.072157. Epub 2007 Jul 27.

35. Ramiro S, Gaujoux-Viala C, Nam JL, et al. Safety of synthetic and biological DMARDs – a systematic literature review informing the 2013 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2013;73(3):529-35. DOI: 10.1136/annrheumdis-2013-204575. Epub 2014 Jan 8.

36. Dixon WG, Bansback N. Understanding the side effects of glucocorticoid therapy: shininh a light on a drug everyone thinks they know. Ann Rheum Dis. 2012;71(11):1761–4. DOI: 10.1136/annrheumdis-2012-202021. Epub 2012 Jul 31.

37. Volkman ER, Rezai S, Tarp S, et al. We still don’t` know how to taper glucocorticoids in rheumatoid arthritis, and we can do better. J Rheumatol. 2013;40(10): 1646–9. DOI: 10.3899/jrheum.130019.

38. Насонов ЕЛ, Каратеев ДЕ, Чичасова НВ. Рекомендации EULAR по лечению ревматоидного артрита – 2013: общая харак-

39. теристика и дискуссионные проблемы. Научно-практическая ревматология. 2013;51(6):609–22. [Nasonov EL, Karateev DE, Chichasova NV. EULAR recommendations for the treatment of rheumatoid arthritis – 2013: general characteristics and disputable problems. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2013;51(6):609–22. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-609-22.

40. Van Tuyl LYD, Boers M, Lems WF, et al. Survival, comorbidities and join damage 11 years after COBRA combination therapy trial in early rheumatoid arthritis. Ann Rheum Dis. 2010;69(5):807–12. DOI: 10.1136/ard.2009.108027. Epub 2009 May 17.

41. Graudal N, Jurgens G. Similar effects of disease-modifying antirheumatic drugs, glucocorticoids, and biologic agents on radiographic progression in rheumatoid arthrits. Meta-analysis of 70 randomized placebocontrolled or drug controlled studies, including 112 comparison. Arthritis Rheum. 2010;62(10):2852–63. DOI: 10.1002/art.27592.

42. Smolen JS, Aletaha D, Bijsma JWJ, et al. For the T2T Expert Committee. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis. 2010;69(4):631–7. DOI: 10.1136/ard.2009.123919. Epub 2010 Mar 9.

43. Wolfe F, Caplan L, Michaud K. Treatment for rheumatoid arthritis and the risk of hospitalisation for pneumonia: association with prednisone, disease-modifying drugs, anti tumor necrosis factor therapy. Arthrits Rheum. 2006;54(2):628–34. DOI: http://dx.doi.org/10.1002/art.21568.

44. Crowson CS, Hoganson DD, Fitz-Gibbon PD, Matteson EL. Development and validation of a risk score for serious infection in patients with rheumatoid arthritis. Arthritis Rheum. 2012;64(9):2847–55. DOI: 10.1002/art.34530.

45. Staa TP, Geusens P, Bijlsma JW, et.al. Clinical assessment of the long-term ris of fracture in patients with rheumatoid arthritis. Arthritis Rheum. 2006;54(10):3104–12. DOI: http://dx.doi.org/10.1002/art.22117.

46. Panoulas VF, Douglas KM, Stavropoulos-Kalinoglou A, et al. Long-term exposure to medium-dose glucocortocoid therapy associates with hypertension in patients with rheumatoid arthritis. Rheumatology (Oxford). 2008;47(1):72–5. DOI: http://dx.doi.org/10.1093/rheumatology/kem311.

47. Чичасова НВ, Владимиров СА, Имаметдинова ГР и др. Функциональные исходы ревматоидного артрита при различных видах противовоспалительной терапии. Научно-практическая ревматология. 2010;48(2):30–6. [Chichasova NV, Vladimirov SA, Imametdinova GR, et al. Functional outcomes of rheumatoid arthritis during various proceduresof anti-inflammatory therapy. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2010;48(2):30–6. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2010-1413.


Для цитирования:


Чичасова Н. Рекомендации EULAR по лечению ревматоидного артрита (2013): использование глюкокортикоидов. Современная ревматология. 2014;8(2):28-34. https://doi.org/10.14412/1996-7012-2014-2-28-34

For citation:


Chichasova N. EULAR recommendation for the management of rheumatoid arthritis (2013): glucocorticoid use. Modern Rheumatology Journal. 2014;8(2):28-34. (In Russ.) https://doi.org/10.14412/1996-7012-2014-2-28-34

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)