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Современная ревматология

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Как вести больного ревматоидным артритом после достижения ремиссии?

https://doi.org/10.14412/1996-7012-2016-1-41-47

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Аннотация

В статье рассматривается весьма актуальная проблема оптимизации ведения больных ревматоидным артритом (РА), достигших состояния ремиссии (или стойко низкой активности болезни) на фоне терапии с применением генно-инженерных биологических препаратов (ГИБП). Проанализированы результаты исследований BeSt, OPTIMA, HIT HARD, ACT-RAY, AVERT, PRESERVE, RETRO, PRIZE, DRESS, HOPEFUL-2, HONOR, данные регистров NinJa и CORRONA, а также опыт, полученный при лечении псориаза, в отношении таких важных в практическом плане вопросов, как: возможность отмены ингибиторов фактора некроза опухоли α и ГИБП с иными механизмами действия, возможность отмены всей противовоспалительной терапии, снижение дозы ГИБП как альтернатива полной отмене или ступень на пути к отмене ГИБП, повторное назначение и «прерывистое лечение» ГИБП, значение глубины подавления воспалительной активности для решения вопроса о возможности отмены ГИБП. На основе полученных к настоящему времени результатов можно заключить, что при РА вероятно успешное снижение дозы, а в некоторых случаях – и полная отмена ГИБП. Такая возможность, по-видимому, связана с глубиной ремиссии. У пациентов с рецидивом активности болезни повторное назначение ГИБП, как правило, приводит к быстрому улучшению. Наиболее оптимистичными выглядят результаты исследований этанерцепта.

Об авторе

Д. Е. Каратеев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


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Для цитирования:


Каратеев Д.Е. Как вести больного ревматоидным артритом после достижения ремиссии? Современная ревматология. 2016;10(1):41-47. https://doi.org/10.14412/1996-7012-2016-1-41-47

For citation:


Karateev D.E. How should a patient with rheumatoid arthritis behave after achievement of remission? Modern Rheumatology Journal. 2016;10(1):41-47. (In Russ.) https://doi.org/10.14412/1996-7012-2016-1-41-47

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