Ревматоидный артрит: достижения и нерешенные проблемы


Цитировать

Полный текст

Аннотация

Несмотря на достигнутые успехи в лечении ревматоидного артрита (РА), связанные с разработкой новых лекарственных препаратов и совершенствованием стратегии лечения, позволяющих достигнуть ремиссии у многих пациентов, остается много теоретических и клинических проблем, касающихся как определения понятия «ремиссия», ее характеристики и типов, так и подходов к оптимальной тактике «симптоматической» и «патогенетической» лекарственной терапии на разных стадиях болезни, применение которой позволит быстро индуцировать состояние ремиссии и поддерживать ее в долгосрочной перспективе. Необходимы дальнейшие исследования, направленные на изучение природы гетерогенности патогенетических механизмов РА, подходов к ранней диагностике, совершенствование методов мониторинга активности заболевания, биомаркеров эффективности и резистентности к терапии и, наконец, разработки дифференцированной терапии, в том числе связанной с поиском новых «терапевтических» мишеней.

Об авторах

Евгений Львович Насонов

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)

Email: nasonov@irramn.ru
акад. РАН, д.м.н., проф., научный руководитель ФГБНУ «НИИР им. В.А. Насоновой» Москва, Россия

Александр Михайлович Лила

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»

д.м.н., проф., директор ФГБНУ «НИИР им. В.А. Насоновой» Москва, Россия

Список литературы

  1. Ревматология. Российские клинические рекомендации. Под ред. Е.Л. Насонова. М.: ГЭОТАР-Медиа, 2017; 456 с.
  2. Аletaha D, Smolen J.S. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018 Oct 2;320(13):1360-72. doi: 10.1001/jama.2018.13103
  3. Mc Innes I.B, Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis. Lancet. 2017;389(10086):2328-37. doi: 10.1016/S0140-6736(17)31472-1
  4. Mc Gonagle D, Watad A, Savic S. Mechanistic immunological based classification of rheumatoid arthritis. Autoimmun Rev. 2018 Nov;17(11):1115-23. doi: 10.1016/j. autrev.2018.06.001
  5. Smolen J.S, Breedveld F.C, Burmester G.R, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016;75:3-15.
  6. Van Vollenhoven R. Treat - to - target in rheumatoid arthritis - are we there yet? Nat Rev Rheumatol. 2019 Jan 30. doi: 10.1038/s41584-019-0170-5
  7. Burmester G.R, Pope J.E. Novel treatment strategies in rheumatoid arthritis. Lancet. 2017;389(10086):2338-48. doi: 10.1016/S0140-6736(17)31491-5
  8. Ajeganova S, Huizinga T. Sustained remission in rheumatoid arthritis: latest evidence and clinical considerations. Ther Adv Musculoskelet Dis. 2017;9(10):249-62. doi: 10.1177/1759720X17720366
  9. Smolen J.S, Aletaha D, Barton A, Burmester G.R, Emery P, Firestein G.S, Kavanaugh A, Mc Innes I.B, Solomon D.H, Strand V, Yamamoto K. Rheumatoid arthritis. Nat Rev Dis Primers. 2018 Feb 8;4:18001. doi: 10.1038/nrdp.2018.1
  10. Schett G, Emery P, Tanaka Y, et al. Tapering biologic and conventional DMARD therapy in rheumatoid arthritis: current evidence and future directions. Ann Rheum Dis. 2016;75:1428-37.
  11. Олюнин Ю.А. Оценка активности заболевания при ревматоидном артрите: рекомендации и практика. Современная ревматология. 2014;2:15-20.
  12. Gaujoux-Viala C, Mouterde G, Baillet A, Claudepierre P, Fautrel B, Le Loët X, Maillefert J.F. Evaluating disease activity in rheumatoid arthritis: which composite index is best? A systematic literature analysis of studies comparing the psychometric properties of the DAS, DAS28, SDAI and CDAI. Joint Bone Spain. 2012;79(2):149-55. doi: 10.1016/j.jbspin.2011.04.008
  13. Ferreira R.J.O, Dougados M, Kirwan J.R, Duarte C, et al. Drivers of patient global assessment in patients with rheumatoid arthritis who are close to remission: an analysis of 1588 patients. Rheumatology (Oxford), 2017;56(9):1573-8. doi: 10.1093/rheumatology/kex211
  14. Nikiphorou E, Radner H, Chatzidionysiou K, et al. Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature. Arthritis Res Ther. 2016;18:251.
  15. Van Nies J.A1, Krabben A, Schoones J.W, Huizinga T.W, Kloppenburg M, van der Helm - van Mil A.H. What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review. Ann Rheum Dis. 2014;73(5):861-70. doi: 10.1136/annrheumdis-2012-203130
  16. Cook M.J, Diffin J, Scirè C.A, Lunt M, Mac Gregor A.J, Symmons D.P, Verstappen S.M. Predictors and outcomes of sustained, intermittent or never achieving remission in patients with recent onset inflammatory polyarthritis: results from the Norfolk. Arthritis Register. 2016;55(9):1601-9. doi: 10.1093/rheumatology/kew210
  17. Michelsen B, Kristianslund E.K, Sexton J, Hammer H.B, Fagerli K.M, et al. Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study. Ann Rheum Dis. 2017;76(11):1906-10. doi: 10.1136/annrheumdis-2017-211284
  18. Matcham F, Davies R, Hotopf M, Hyrich K.L, Norton S, Steer S, Galloway J. The relationship between depression and biologic treatment response in rheumatoid arthritis: An analysis of the British Society for Rheumatology Biologics Register. Rheumatology (Oxford). 2018;57(5):835-43. doi: 10.1093/rheumatology/kex528
  19. Vittecoq O, Richard L, Banse C, Lequerré T. The impact of smoking on rheumatoid arthritis outcomes. Join Bone Spine. 2018;85(2):135-8. doi: 10.1016/j.jbspin. 2017. 12.004
  20. Juan S, Jiabi Z. Impact of obesity on the efficacy of different biologic agents in inflammatory diseases: a systematic review and meta - analysis. Joint Bone Spine. 2018 Apr 7. pii: S1297-319X(18)30050-2. doi: 10.1016/j.jbspin.2018.03.007
  21. Martin-Mola E, Balsa A, García-Vicuna R, Gómez-Reino J, González-Gay M.A, Sanmartí R, Loza E. Anti - citrullinated peptide antibodies and their value for predicting responses to biologic agents: a review. Rheumatol Int. 2016;36(8):1043-63. doi: 10.1007/s00296-016-3506-3
  22. Buch M.H. Defining refractory rheumatoid arthritis. Ann Rheum Dis. 2018;77:966-9. doi: 10.1136/annrheumdis-2017-212862
  23. De Hair M.J.H, Jacobs J.W.G, Schoneveld J.L.M, et al. Difficult - to - treat rheumatoid arthritis: an area of unmet clinical need. Rheumatology. 2017. doi:10.1093/ rheumatology/kex349
  24. Kearsley-Fleet L, De Cock D, Watson K, et al. Refractory disease in rheumatoid arthritis: results from the British society of rheumatology biologics register for rheumatoid arthritis. Arthritis Rheumatol. 2017;69.
  25. Smolen J.S, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. Nat Rev Rheumatol. 2015 May;11(5):276-89. doi: 10.1038/ nrrheum.2015.8
  26. Lee Y.C, Frits M.L, Iannaccone C.K, et al. Subgrouping of patients with rheumatoid arthritis based on pain, fatigue, inflammation, and psychosocial factors. Arthritis Rheumatol. 2014;66:2006-14. doi: 10.1002/art.38682
  27. Haliloglu S, Carlioglu A, Akdeniz D, Karaaslan Y, Kosar A. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Rheumatol Int. 2014;34:1275-80.
  28. Atzeni F, Cazzola M, Benucci M, et al. Chronic widespread pain in the spectrum of rheumatological diseases. Best Pract Res Clin Rheumatol. 2011;25:165-71.
  29. Mian A.N, Chaabo K, Wajed J, et al. Rheumatoid arthritis patients with fibromyalgic clinical features have significantly less synovitis as defined by power Doppler ultrasound. BMC Musculoskelet Disord. 2016;17:404.
  30. Unger M, Alasti F, Supp G, Smolen J.S, Aletaha D. The good, the bad and the ugly - refractory rheumatoid arthritis in 2016. Arthritis Rheumatol. 2016;68(Suppl 10): Abstract No. 3015. http://acrabstracts.org/abstract/the-good-the-bad-and-the-ugly-refractory-rheumatoid-arthritis-in-2016/
  31. Orange D.E, Agius P, Di Carlo E.F, Robine N, Geiger H, et al. Identification of Three Rheumatoid Arthritis Disease Subtypes by Machine Learning Integration of Synovial Histologic Features and RNA Sequencing Data. Arthritis Rheumatol. 2018;70(5):690-701. doi: 10.1002/art.40428
  32. Basu N, Kaplan C.M, Ichesco E, et al. Neurobiological features of fibromyalgia are also present amond rheumatoid arthritis patients. Arthritis Rheumatol. 2018 Feb 13. doi: 10.1002/art.40451
  33. George M, Baker J.F. The obesity epidemic and consequences for rheumatoid arthritis care. Curr Rheumatol Rep. 2016;18:6.
  34. Pasma A, van Spijker A, Hazes J.M.W, Busschbach J.J.V, Luime J.J. Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: a systematic review. Semin Arthritis Rheum. 2013;43:18-28.
  35. Romão V.C, Vital E.M, Fonseca J.E, et al. Right drug, right patient, right time: aspiration or future promise for biologics in rheumatoid arthritis? Arthritis Res Ther. 2017;19:1-13. doi: 10.1186/s13075-017-1445-3
  36. Schaeverbeke T, Truchetet M.E, Kostine M, et al. Immunogenicity of biologic agents in rheumatoid arthritis patients: lessons for clinical practice. Rheumatology. 2016;55: 210-20.
  37. Schwartz D.M, Kanno Y, Villarino A, Ward M, Gadina M, O'Shea J.J. JAK inhibition as a therapeutic strategy for immune and inflammatory diseases. Nat Rev Drug Discov. 2017;16(12):843-62. doi: 10.1038/nrd.2017.201
  38. Banerjee S, Biehl A, Gadina M, Hasni S, Schwartz D.M. JAK-STAT Signaling as a Target for Inflammatory and Autoimmune Diseases: Current and Future Prospects. Drugs. 2017;77(5):521-46. doi: 10.1007/s40265-017-0701-9
  39. Gadina M, Johnson C, Schwartz D, Bonelli M, Hasni S, et al. Translational and clinical advances in JAK-STAT biology: The present and future of jakinibs. J Leukoc Biol. 2018;104(3):499-514. doi: 10.1002/JLB.5RI0218-084R
  40. Smolen J.S, Landewé R, Bijlsma J, Burmester G, Chatzidionysiou K, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease - modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;76(6):960-77. doi: 10.1136/annrheumdis-2016-210715
  41. Singh J.A, Saag K.G, Bridges S.L, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016;68(1):1-26. doi: 10.1002/art.39480
  42. Smolen J.S, van der Heijde D, Machold K.P, Aletaha D, Landewé R. Proposal for a new nomenclature of disease - modifying antirheumatic drugs. Ann Rheum Dis. 2014;73(1):3-5. doi: 10.1136/annrheumdis-2013-204317
  43. Al-Salama Z.T, Scott L.J. Baricitinib: A Review in Rheumatoid Arthritis. Drugs. 2018 May;78(7):761-72. doi: 10.1007/s40265-018-0908-4
  44. Genovese M.C, Kremer J, Zamani O, et al. Baricitinib in patients with refractory rheumatoid arthritis. N Engl J Med. 2016;374:1243-52.
  45. Genovese M.C, Kremer J.M, Kartman C.E, Schlichting D.E, Xie L, et al. Response to baricitinib based on prior biologic use in patients with refractory rheumatoid arthritis. Rheumatology (Oxford). 2018 May 1;57(5):900-8. doi: 10.1093/rheumatology/kex 489
  46. Schiff M, Kelly S, Le Bars M, Genovese M. Efficacy of abatacept in RA patients with an inadequate response to anti-TNF therapy regardless of reason for failure, or type or number of prior anti-TNF therapy used. Ann Rheum Dis. 2008;67(Suppl 2):337.
  47. Smolen J.S, Kay J, Doyle M.K, et al. Golimumab in patients with active rheumatoid arthritis after treatment with tumour necrosis factor α inhibitors (GO-AFTER study): a multicentre, randomised, double - blind, placebo - controlled, phase III trial. Lancet. 2009;374:210-21.
  48. Kremer J.M, Tony H, Tak P.P, Luggen M, Mariette X, Hessey E. Efficacy of ritumixab in active RA patients with an inadequate response to one or more TNF inhibitors. Ann Rheum Dis. 2006;65(Suppl 2):326.
  49. Cain D.W, Cidlowski J.A. Immune regulation by glucocorticoids. Nat Rev Immunol. 2017 Apr;17(4):233-47. doi: 10.1038/nri.2017.1
  50. Ridgley L.A, Anderson A.E, Pratt A.G. What are the dominant cytokines in early rheumatoid arthritis? Curr Opin Rheumatol. 2018;30(2):207-14. doi: 10.1097/BOR
  51. Mc Innes I.B, Buckley C.D, Isaacs J.D. Cytokines in rheumatoid arthritis - shaping the immunological landscape. Nat Rev Rheumatol. 2016 Jan;12(1):63-8. doi:10.1038/ nrrheum.2015.171
  52. Conrad C, Di Domizio J, Mylonas A, Belkhodja C, Demaria O, et al. TNF blockade induces a dysregulated type I interferon response without autoimmunity in paradoxical psoriasis. Nat Commun. 2018;9(1):25. doi: 10.1038/s41467-017-02466-4
  53. Toussirot É, Aubin F. Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune - mediated diseases: an analytical and comprehensive overview. RMD Open. 2016 Jul 15;2(2):e000239. doi: 10.1136/ rmdopen-2015-000239
  54. Strand V, Balsa A, Al-Saleh J, Barile-Fabris L, Horiuchi T, Takeuchi T, Lula S, Hawes C, Kola B, Marshall L. Immunogenicity of Biologics in Chronic Inflammatory Diseases: A Systematic Review. BioDrugs. 2017;31(4):299-316. doi: 10.1007/ s40259-017-0231-8

© ООО "Консилиум Медикум", 2019

Creative Commons License
Эта статья доступна по лицензии Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


Данный сайт использует cookie-файлы

Продолжая использовать наш сайт, вы даете согласие на обработку файлов cookie, которые обеспечивают правильную работу сайта.

О куки-файлах