Preview

Научно-практическая ревматология

Расширенный поиск

Рекомендации EULAR по лечению ревматоидного артрита – 2013: общая характеристика и дискуссионные проблемы

https://doi.org/10.14412/1995-4484-2015-18-31

Полный текст:

Аннотация

Последнее десятилетие ознаменовалось существенным прогрессом в изучении ревматоидного артрита (РА), для лечения которого в настоящее время разработано 9 инновационных генно-инженерных биологических препаратов (моноклональные антитела и рекомбинантные белки), ингибирующих активность важнейших провоспалительных цитокинов и патологическую активацию Ти В-лимфоцитов, участвующих в развитии иммуновоспалительного процесса. Однако кардинальное улучшение прогноза при РА зависит не только от внедрения инновационных лекарственных средств, но и от совершенствования стратегии лечения. Эта стратегия базируется на ранней диагностике, которая определяет возможность инициации очень ранней («окно возможности») активной тщательно контролируемой (tight control) противовоспалительной терапии, цель которой – максимально быстрое достижение ремиссии (концепция «Лечение до достижения цели» – Treat to Target). Концепция «Лечение до достижения цели», сформулированная EULAR в 2010 г., широко инкорпорирована в национальные рекомендации по лечению РА, разработанные во многих странах мира, в том числе в России. В 2013 г. была подготовлена новая версия рекомендаций EULAR, которая аккумулировала научные достижения и клинический опыт, накопленный за последние 3 года. Целями публикации являются общая характеристика основных положений новых рекомендаций и обсуждение некоторых нерешенных и дискуссионных проблем, требующих дальнейшего изучения.

Об авторах

Е. Л. Насонов
ФГБУ «Научно- исследовательский институт ревматологии им. В.А. Насоновой» РАМН, Москва, Россия
Россия


Д. Е. Каратеев
ФГБУ «Научно- исследовательский институт ревматологии им. В.А. Насоновой» РАМН, Москва, Россия
Россия


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


Список литературы

1. Насонов ЕЛ, Каратеев ДЕ, Балабанова РМ. Ревматоидный артрит. В кн. Ревматология. Национальное руководство. Насонов ЕЛ, Насонова ВА, редакторы. Москва: ГЭОТАРМедиа; 2008. с. 290–331. [Nasonov EL, Karateev DE, Balabanova RM. Revmatoidnyi artrit. V kn. Revmatologiya. Natsional'noe rukovodstvo. Nasonov EL, Nasonovа VA, editors. Moscow: GEOTAR-Media; 2008. p. 290–331.]

2. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205–19. DOI: 10.1056/NEJMra1004965.

3. Smolen JS, Aletaha D, Koeller M, et al. New therapies for treatment of rheumatoid arthritis. Lancet. 2007;370(9602):1861–71. DOI: http://dx.doi.org/10.1016/S0140–6736(07)60784–3.

4. Furst DE, Keystone EC, Braun J, et al. Update consensus statement on biological agents for the treatment of rheumatic disease, 2011. Ann Rheum Dis. 2012;71 Suppl 2:i2–45. DOI: 10.1136/annrheumdis-2011-201036.

5. Насонов ЕЛ, редактор. Генно-инженерные биологические препараты в лечении ревматоидного артрита. Москва: ИМА-ПРЕСС; 2013. [Nasonov EL, editor. Genno-inzhenernye biologicheskie biologicheskie preparaty v lechenii revmatoidnogo artrita. Moscow: IMA-PRESS; 2013.]

6. Sokka T, Pincus T. Rheumatoid arthritis: strategy more important than agent. Lancet. 2009;374(9688):430–2. DOI: 10.1016/S0140–6736(09)61432-X.

7. Smolen JS, Aletaha D, Bijsma JW, 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.

8. Smolen JS, 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.

9. Aletaha D, Neogri T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria. An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–81. DOI: 10.1002/art.27584.

10. Felson DT, Smolen JS, Wells G, et al. American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Arthritis Rheum. 2011;63(3):573–86. DOI: 10.1002/art.30129.

11. Smolen JS, van der Heijde D, Machold KP, et al. Proposal for a new nomenclature of disease-modifying antirheumatic drugs. Ann Rheum Dis. 2014;73(1):3–5. DOI: 10.1136/annrheumdis2013-204317. Epub 2013 Sep 26.

12. Mok CC, Tam LS, Chan TH, et al. Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology. Clin Rheumatol. 2011;30(3):303–12. DOI: 10.1007/s10067-010-1596-y. Epub 2010 Nov 3.

13. El Zorkany B, Alwahshi HA, Hammoudeh M, et al. Suboptimal management of rheumatoid arthritis in the Middle East and Africa: could the EULAR recommendations be the start of a solution? Clin Rheumatol. 2013;32(2):151–9. DOI: 10.1007/s10067012-2153-7. Epub 2012 Dec 30.

14. Wollenhaupt J, Albrecht K, Kruger K, et al. The new 2012 German recommendations for treating rheumatoid arthritis: differences compared to the European standpoint. Z Rheumatol. 2013;72(1):6–9. DOI: 10.1007/s00393-012-1093-6..

15. Bykerk VP, Akhavan P, Hazlewood GS, et al. Canadian Rheumatology Association recommendations for pharmacological management of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs. J Rheumatol. 2012;39(8):1559–82. DOI: 10.3899/jrheum.110207. Epub 2011 Sep 15.

16. Национальные рекомендации по лечению ревматоидного артрита, 2013 (проект). Доступ по ссылке: www.rheumatolog.ru [Natsional'nye rekomendatsii po lecheniyu revmatoidnogo artrita, 2013 (proekt). Available from: www.rheumatolog.ru]

17. 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. 2013 Oct 25. DOI: 10.1136/annrheumdis-2013-204573.

18. Radner H, Neogi T, Smolen JS, Aletaha D. Performance of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: a systematic literature review. Ann Rheum Dis. 2014;73(1):114–23. DOI: 10.1136/annrheumdis-2013-203284. Epub 2013 Apr 16.

19. Kavanaugh A, Fleischmann RM, Emery P, et al. Clinical, functional and radiographic consequences of achieving stable low disease activity and remission with adalimumab plus methotrexate or methotrexate alone in early rheumatoid arthritis: 26-week results from the randomised, controlled OPTIMA study. Ann Rheum Dis. 2013;72(1):64–71. DOI: 10.1136/annrheumdis-2011201247. Epub 2012 May 5.

20. Gabay C, Emery P, van Vollenhoven R, et al. Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial. Lancet. 2013;381(9877):1541–50. DOI: 10.1016/S0140-6736(13)60250-0. Epub 2013 Mar 18.

21. Mierau M, Schoels M, Gonda G, et al. Assessing remission in clinical practice. Rheumatology. 2007;46(6):975–9. DOI: http://dx.doi.org/10.1093/rheumatology/kem007. Epub 2007 Mar 6.

22. Klarenbeek NB, Koevoets R, van der Heijde DM, et al. Association with joint damage and physical functioning of nine composite indices and the 2011 ACR/EULAR remission criteria in rheumatoid arthritis. Ann Rheum Dis. 2011;70(10):1815–21. DOI: 10.1136/ard.2010.149260. Epub 2011 Aug 3.

23. Koevoets R, van der Heijde D. Being in remission or in low disease activity in rheumatoid arthritis: different meaning with the use of different composite scores. Arthritis Rheum. 2009;60(Suppl):957.

24. Smolen JS, Han C, van der Heijde DM, et al. Radiographic changes in rheumatoid arthritis patients attaining different disease activity states with methotrexate monotherapy and infliximab plus methotrexate: the impacts of remission and TNF-blockade. Ann Rheum Dis. 2009;68(6):823–7. DOI: 10.1136/ard.2008.090019. Epub 2008 Jul 1.

25. Aletaha D, Smolen JS. Joint damage in rheumatoid arthritis progresses in remission according to the Disease Activity Score in 28 joints and is driven by residual swollen joints. Arthritis Rheum. 2011;63(12):3702–11. DOI: 10.1002/art.30634.

26. Balsa A, de Miguel E, Castillo C, et al. Superiority of SDAI over DAS-28 in assessment of remission in rheumatoid arthritis patients using power Doppler ultrasonography as a gold standard. Rheumatology (Oxford). 2010;49(4):683–90. DOI: 10.1093/rheumatology/kep442. Epub 2010 Jan 4.

27. Sakellariou G, Scire CA, Verstappen SM, et al. In patients with early rheumatoid arthritis, the new ACR/EULAR definition of remission identifies patients with persistent absence of functional disability and suppression of ultrasonographic synovitis. Ann Rheum Dis. 2013;72(7):245–9. DOI: 10.1136/annrheumdis2012-201817. Epub 2012 Oct 11.

28. Gartner M, Mandl P, Radner H, et al. Sonographic joint assessment in rheumatoid arthritis: Associations with clinical joint assessment in remission. Arthritis Rheum. 2013;65(8):2005–14. DOI: 10.1002/art.38016.

29. Aletaha D, Landewe R, Karonitsch T, et al. Reporting disease activity in clinical trials of patients with rheumatoid arthritis: EULAR/ACR collaborative recommendations. Ann Rheum Dis. 2008;67(10):1360–4. DOI: 10.1136/ard.2008.091454.

30. Radner H, Smolen JS, Aletaha D. Comorbidity affects all domains of physical function and quality of life in patients with rheumatoid arthritis. Rheumatology (Oxford). 2011;50(2):381–8. DOI: 10.1093/rheumatology/keq334. Epub 2010 Oct 29.

31. Kiely P, Walsh D, Williams R, et al. Outcome in rheumatoid arthritis patients with continued conventional therapy for moderate disease activity – the early RA network (ERAN). Rheumatology (Oxford) 2011;50(5):926–31. DOI: 10.1093/rheumatology/keq406. Epub 2010 Dec 17.

32. Montag K, Gingold M, Boers A, et al. Disease-modifying antirheumatic drug usage, prescribing patterns and disease activity in rheumatoid arthritis patients in community-based practice. Intern Med J. 2011;41(6):450–5. DOI: 10.1111/j.14455994.2010.02240.x. Epub 2010 Apr 12.

33. Aletaha D, Funovits J, Keystone EC, et al. Disease activity early in the course of treatment predicts response to therapy after one year in rheumatoid arthritis patients. Arthritis Rheum. 2007;56(10):3226–35. DOI: http://dx.doi.org/10.1002/art.22943.

34. Visser K, van der Heijde D. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature. Ann Rheum Dis. 2009;68(7):1094–9. DOI: 10.1136/ard.2008.092668. Epub 2008 Nov 25.

35. Насонов ЕЛ. Лечение ревматоидного артрита 2012: место метотрексата. Научно-практическая ревматология. 2012;51 (приложение):1–24. [Nasonov EL. Lechenie revmatoidnogo artrita 2012: mesto metotreksata. Rheumatology Science and Practice. 2012;51 (prilozhenie):1–24].

36. 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. 2013.

37. Pincus T, Yazici Y, Sokka T, et al. Methotrexate as the «anchor drug» for the treatment of early rheumatoid arthritis. Clin Exp Rheumatol. 2003;21(5 Suppl 31):S179–85.

38. Breedveld FC, Weisman MH, Kavanaugh AF, et al. The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum. 2006;54(1):26–37. DOI: http://dx.doi.org/10.1002/art.21519.

39. St Clair EW, van der Heijde DM, Smolen JS, et al. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum. 2004;50(11):3432–43.

40. Klareskog L, van der Heijde D, de Jager JP, et al. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet. 2004;363(9410):675–81. DOI: http://dx.doi.org/10.1016/S01406736(04)15640-7.

41. Tak PP, Rigby WF, Rubbert-Roth A, et al. Inhibition of joint damage and improved clinical outcomes with rituximab plus methotrexate in early active rheumatoid arthritis: the IMAGE trial. Ann Rheum Dis. 2011;70(1):39–46. DOI: 10.1136/ard.2010.137703. Epub 2010 Oct 11.

42. Westhovens R, Robles M, Ximenes AC, et al. Clinical efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis and poor prognostic factors. Ann Rheum Dis. 2009;68(12):1870–7. DOI: 10.1136/ard.2008.101121. Epub 2009 Jan 5.

43. 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. Published Online First: 28 May 2013. DOI:10.1136/annrheumdis2013-203243.

44. Baker M, Jacobs JWG, Welsing PMJ, et al. Low-dose prednisone inclusion in a methotrexate-based, tight control strategy for early rheumatoid arthritis. Ann Intern Med. 2012;156(5):329–39. DOI: 10.7326/0003-4819-156-5-201203060-00004.

45. Vermeer M, Kuper HH, Hoekstra M, et al. Implementation of a Threat-to-Target Strategy in very Early Rheumatoid Arthritis. Results of the Dutch Rheumatoid Arthritis Monitoring Remission Induction Cohort Study. Arthritis Rheum. 2011;63(10):2865–72. DOI: 10.1002/art.30494.

46. Vermeer M, Kuper H.H., Bernelot Moens H.J., et al. Sustained beneficial effects of a protocolized treat-to-target strategy in very early rheumatoid arthritis: three year results of the DREAM remission induction cohort. Arthritis Care Res. 2013;65(8):1219–26. DOI: 10.1002/acr.21984.

47. Horslev-Petersen K, Hertland ML, Junker P, et al. Adalimumab added to a treat-to-target strategy with methotrexate and intraarticular triamcinolone in early rheumatoid arthritis increased remission rates, function and quality of life. The OPERA study; an investigator-initiated, randomized, double-blind, parallelgroup, placebo-controlled trial. Ann Rheum Dis. 2013 Mar 7. DOI: 10.1136/annrheumdis-2012-202735.

48. Detert J, Bastian H, Listing J, et al. Induction therapy with adalimumab plus methotrexate for 24 weeks followed by methotrexate monotherapy up to week 48 versus methotrexate therapy alone for DMARD-naive patients with early rheumatoid arthritis: HITHARD, an investigator-initiated study. Ann Rheum Dis. 2013;72(6):844–50. DOI: 10.1136/annrheumdis-2012-201612. Epub 2012 Jun 27.

49. Moreland LW, O’Dell JR, Paulus H, et al. TEAR: treatment of early aggressive RA; A randomized, double-blind, 2-year trial comparing immediate triple DMARD versus MTX plus etanercept to step-up from initial MTX monotherapy. Arthritis Rheum. 2012;64(9):2824–35. DOI: 10.1002/art.34498.

50. O’Dell JR, Mikuls TR, Taylor TH, et al. Therapies for active rheumatoid arthritis after methotrexate failure. N Engl J Med. 2013;369(4):307–18. DOI: 10.1056/NEJMoa1303006. Epub 2013 Jun 11.

51. Wevers-de Boer K, Visser K, Heimans L, et al. Remission induction therapy with methotrexate and prednisolon in patients with early rheumatoid and indifferentiated arthritis (the IMPROVED study). Ann Rheum Dis. 2012;71(9):1472–7. DOI:10.1136/annrheumdos-2011-200736.

52. Leirisalo-Repo M, Kautinen H, Laasonen L, et al. Infliximab for 6 months added on combination therapy in early rheumatoid arthritis: 2 year results from an investigator-initiated, randomized, double-blind, placeb-controlled study (the NEO-RACo Study). Ann Rheum Dis. 2013;72(6):851–7. DOI: 10.1136/annrheumdis2012-201365. Epub 2012 Jun 30.

53. Rantalaiho V, Kautianen H, Korpela M, et al. Targeted treatment with a combination of traditional DMARDs produces exellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regadless of initial infliximab. The 5-tear follow-up results of a randomized clinical trial, the NEO-RACo trial. Ann Rheum Dis. 2013 Oct 28. DOI: 10.1136/annrheumdis-2013203497.

54. Nam JR, Villeneuve E, Hensor EME, et al. Remission induction comparing infliximab and high-dose intravenous steroids, followed by treat-to tergetr: a double-blind, randomized, controlled trial in new-onset, treatment-naive, rheumatoid arthritis (the IDEA study). Ann Rheum Dis. 2014 Jan 1;73(1):75-85. DOI: 10.1136/annrheumdis-2013-203440. Epub 2013 Aug 2.

55. De Jong PH, Hazes JM, Barenndregt PJ, et al. Induction therapy with a combination of DMARDs is better than methotrexate monotherapy: first results of the tREACH trial. Ann Rheum Dis. 2013;72(1):72–8. DOI: 10.1136/annrheumdis-2011-201162. Epub 2012 Jun 7.

56. Salliot C, van der Heijde D. Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research. Ann Rheum Dis. 2009;68(7):1100–4. DOI: 10.1136/ard.2008.093690. Epub 2008 Dec 5.

57. Shea B, Swinden MV, Tanjong Ghogomi E, et al. Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev, 2013 May 31; 5:CD000951. doi: 1002/14651858.CD000951.pub2.

58. Burmester G, Kivitz A, Kupper H, et al. Efficacy, pharmacokinet

59. ics, and safety of different doses of methotrexate in combination with adalimumab: results from the CONCERTO trial. Ann Rheum Dis. 2013;72 Suppl 3:72.

60. Katchamart W, Trudeau J, Phumethum V, Bombardier C. Efficacy and toxicity of methotrexate (MTX) monotherapy versus MTX combination therapy with non-biological disease-modifying antirheumatic drugs in rheumatoid arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2009;68(7):1105–12.DOI: 10.1136/ard.2008.099861. Epub 2008 Dec 3.

61. Насонов ЕЛ, Амирджанова ВН, Беневоленская ЛИ и др. Лечение ревматоидного артрита. Клинические рекомендации. Москва: Алмаз; 2006. 118 с. [Nasonov EL, Amirdzhanova VN, Benevolenskaya LI i dr. Lechenie revmatoidnogo artrita. Klinicheskie rekomendatsii. Moscow: Almaz; 2006. 118 p.]

62. Van der Heijde DM, van Riel PL, Nuver-Zwart IH, et al. Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet. 1989;1(8646):1036–8. DOI: http://dx.doi.org/10.1016/S0140-6736(89)92442-2.

63. Smolen JS, Kalden JR, Scott DL, et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multicentre trial. Lancet. 1999;353(9149):259–66. DOI: http://dx.doi.org/10.1016/S0140-6736(98)09403-3.

64. Sharp JT, Strand V, Leung H, et al. Treatment with leflunomide slows radiographic progression of rheumatoid arthritis. Results from three randomized controlled trials of leflunomide in patients with active rheumatoid arthritis. Arthritis Rheum. 2000;43(3):495–505. DOI: http://dx.doi.org/10.1002/15290131(200003)43:3%3C495:AID-ANR4%3E3.0.CO;2-U.

65. Strand V, Cohen S, Schiff M, et al. Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate. Arch Int Med. 1999;159(21):2542–50. DOI: http://dx.doi.org/10.1001/archinte.159.21.2542.

66. Dougados M, Combe B, Cantagrel A, et al. Combination therapy in early rheumatoid arthritis: a randomised, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components. Ann Rheum Dis. 1999;58(4):220–5. DOI: http://dx.doi.org/10.1136/ard.58.4.220.

67. Micha R, Imamura F, Wyler von Ballmoos M, et al. Systemic review and meta-analysis of methotrexate use and risk of cardiovascular disease. Am J Cardiol. 2011 Nov 1;108(9):1362-70. DOI: 10.1016/j.amjcard.2011.06.054. Epub 2011 Aug 17.

68. Weslake SL, Colebatch AN, Baird J, et al. The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systemic literature review. Rheumatology (Oxford). 2010;49(2):295–307. DOI: 10.1093/rheumatology/kep366. Epub 2009 Nov 27.

69. Попкова ТВ, Герасимова ЕВ, Новикова ДС, Насонов ЕЛ. Метотрексат и риск сердечно-сосудистых осложнений при ревматоидном артрите. Научно-практическая ревматология. 2012;50(6):70–9. [Popkova TV, Gerasimova EV, Novikova DS, Nasonov EL. Methotrexate and cardiovascular risk in rheumatoid arthritis. Rheumatology Science and Practice. 2012;50(6):70–9.]. DOI: http://dx.doi.org/10.14412/1995-4484-2012-1297.

70. Wasko MC, Dasgupts A, Hubert H, et al. Propensity-adjusted association of methotrexate with overall survival in rheumatoid arthritis. Arthritis Rheum. 2013;65(2):334–42. DOI: 10.1002/art.37723.

71. Ostensen M, Forger F. Management of RA medications in pregnant patients. Nat Rev Rheumatol. 2009;5(7):382–90. DOI: 10.1038/nrrheum.2009.103. Epub 2009 Jun 9.

72. Gaujoux-Viala C, Smolen JS, Landewe R, et al. Current evidence for the management of rheumatoid arthritis with synthetic disease modifying antirheumatic drugs: A systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2010;69(6):1004–9. DOI: 10.1136/ard.2009.127225. Epub 2010 May 6.

73. Van Vollenhoven RF, Geborek P, Forslind K, et al. Conventional combination treatment versus biological treatment in methotrexate-refractory early rheumatoid arthritis: 2 year follow-up of the randomised, non-blinded, parallel-group Swefot trial. Lancet. 2012;379(9827):1712–20. DOI: 10.1016/S0140-6736(12)60027-0. Epub 2012 Mar 29..

74. Klarenbeek NB, Guler-Yuksel M, van der Kooij SM, et al. The impact of four dynamic, goal-steered treatment strategies on the 5-year outcomes of rheumatoid arthritis patients in the BeSt study. Ann Rheum Dis. 2011;70(6):1039–46. DOI: 10.1136/ard.2010.141234. Epub 2011 Mar 17.

75. De Jong PHPD, Hazes JM, Luime JJ, et al. Randomized comparison of triple DMARD therapy with methotrexate mono-therapy. Ann Rheum Dis. 2013; 72 Suppl 3:113.

76. Roux CH, Breuil V, Valerio L, et al. Etanercept compared to intraarticular corticosteroid injection in rheumatoid arthritis: double-blind, randomized pilot study. J Rheumatol. 2011;38(6):1009–11. DOI: 10.3899/jrheum.100828. Epub 2011 Mar 16.

77. Dernis E, Ruyssen-Witrand A, Mouterde G, et al. Use of glucocorticoids in rheumatoid arthritis – pratical modalities of glucocorticoid therapy: recommendations for clinical practice based on data from the literature and expert opinion. Joint Bone Spine. 2010;77(5):451–7. DOI: 10.1016/j.jbspin.2009.12.010. Epub 2010 May 14.

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

79. Hoes JN, Jacobs JW, Boers M, et al. EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2007;66(12):1560–7. Epub 2007 Jul 27.

80. Ramiro S, Gaujoux-Viala C, Nam JL, et al. Safety of syntheticand biological DMARDs – a systematic literature review informing the 2013 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis. 2013; submitted.

81. Gorter SL, Bijlsma JW, Cutolo M, et al. Current evidence for the management of rheumatoid arthritis with glucocorticoids: a systemic 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.

82. 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

83. 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 .

84. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allart CF, et al. Patients preferences for treatment: report from a randomized comparison of treatment strategies in early rheumatoid arthritisd (BeST trial). Ann Rheum Dis. 2007;66(9):1227–32. DOI: 10.1136/ard.2006.068296.

85. Vastesaeger N, Xu S, Aletaha D, et al. A pilot risk model for the prediction of rapid radiographic progression in rheumatoid arthritis. Rheumatology (Oxford). 2009;48(9):1114–21. DOI: 10.1093/rheumatology/kep155. Epub 2009 Jul 9.

86. Visser K, Goekoop-Ruiterman YP, de Vries-Bouwstra JK, et al. A matrix risk model for the prediction of rapid radiographic progression in patients with rheumatoid arthritis receiving different dynamic treatment strategies: post hoc analyses from the BeSt study. Ann Rheum Dis. 2010;69(7):1333–7. DOI: 10.1136/ard.2009.121160. Epub 2010 May 24.

87. 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(4):645–8.

88. Dalrymple JM, Stamp LK, O’Donnell JL, et al. Pharmacokinetics of oral methotrexate in patients with rheumatoid arthritis. Arthritis Rheum. 2008;58(11):3299–308. DOI: 10.1002/art.24034.

89. Dervieux T, Zablocki R, Kremer J. Red blood cell methotrexate polyglutamates emerge as a function on dosage intensity and rout of administration during pulse methotrexate therapy in rheumatoid arthritis. Rheumatology (Oxford). 2010;49(12):2337–45. DOI: 10.1093/rheumatology/keq216. Epub 2010 Aug 16.

90. 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: 10.3899/jrheum.110481. Epub 2011 Oct 1.

91. Hamilton RA, Kremer JM. Why intramuscular methotrexate may be more efficacious than oral dosing in patients with rheumatoid arthritis. Brit J Rheumatol. 1997;36(1):86–90. DOI: http://dx.doi.org/10.1093/rheumatology/36.1.86.

92. Rozin A, Scharpira D, Balbir-Gurman A, et al. Relapse of rheumatoid arthritis after substitution of oral for parental administration of methotrexate. Ann Rheum Dis. 2002;61(8):756–7. DOI: http://dx.doi.org/10.1136/ard.61.8.756.

93. Bingman SJ, Buch MH, Lindsay S, et al. Parenteral methotrexate should be given before biological therapy. Rheumatology (Oxford). 2003;42(8):1009–10. DOI: http://dx.doi.org/10.1093/rheumatology/keg246.

94. Wegrzyn J, Adeleine P, Miossec P. Better efficacy of methotrexate given by intramuscular injection than orally in patients with rheumatoid arthritis. Ann Rheum Dis. 2004;63(10):1232–4. DOI: http://dx.doi.org/10.1136/ard.2003.011593.

95. Moitra RK, Ledingham 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. DOI: http://dx.doi.org/10.1093/rheumatology/keh471. Epub 2005 Jan

96. Osman A, Mulherin D. Is parental methotrexate worth trying. Ann Rheum Dis. 2001;60(4):432. DOI: http://dx.doi.org/10.1136/ard.60.4.432.

97. Burbage G, Gupta R, Lim K. Intramuscular methotrexate in inflammatory rheumatic disease. Ann Rheum Dis. 2001;60(12):1156. DOI: http://dx.doi.org/10.1136/ard.60.12.1156.

98. Rutkowska-Sak L, Rell-Bakalarska M, Lisowska B. Oral vs. subcutaneous low-dose methotrexate treatment in reducing gastrointestinal side effects. Rheumatologia. 2009;47:207–11.

99. Linde L, Hetland ML, Ostergaard M. Drug survival and reasons for discontinuation of intramuscular methotrexate: a study of 212 consecutive patients switching from oral methotrexate. Scand J Rheumatol. 2006;35(2):102–6. DOI: http://dx.doi.org/10.1080/03009740500343294.

100. Муравьев ЮВ, Денисов ЛН, Алексеева АВ и др. Открытое контролируемое рандомизированное 24-недельное сравнительное исследование инъекционной и таблетированной лекарственных форм метотрексата при ревматоидном артрите. Научно-практическая ревматология. 2011;(5):58–61. [Muravyev YV, Denisov LN, Alekseyeva AV, et al. 24-week open-label controlled randomized comparative study of the injectable and tabletted formulations of methotrexate in rheumatoid arthritis. Rheumatology Science and Practice. 2011;(5):58–61.]

101. Braun, J, Kastner P, Flaxenberg P, et al. Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: results of a six-month, multicenter, randomized, double-blind, controlled, phase IV trial. Arthritis Rheum. 2008;58(1):73–81. DOI: 10.1002/art.23144.

102. Bakker MF, Jacobs JW, Welsing PM, et al. Are switching from oral to subcutaneous methotrexate or additional of cyclosporine to methotrexate useful steps in tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study. Ann Rheum Dis. 2010;69(10):1849–52. DOI: 10.1136/ard.2009.124065. Epub 2010 May 28.

103. Mainman H, McClaren E, Heycock C, et al. When should we use parental methotrexate? Clin Rheumatol. 2010;29(10):1093–8. DOI: 10.1007/s10067-010-1500-09.

104. Scott D, Claydon P, Ellis C, Buchan S. A retrospective study of the effect of switching from oral to subcutaneous (SC) methotrexate (MTX): the Methotrexate Evaluation of Norwich Treatment Outcomes in RA (MENTOR) study. Glasgow, UK: British Soc Rheumatology; 2012. P. 221.

105. Каратеев ДЕ, Лучихина ЕЛ, Муравьев ЮВ и др. Первое российское стратегическое исследование фармакотерапии ревматоидного артрита (РЕМАРКА). Научно-практическая ревматология. 2013;51(2):117–25. [Karateev DE, Luchikhina EL, Muravyev YV, et al. The first Russian strategic study of pharmacotherapy for rheumatoid arthritis (REMARCA). Rheumatology Science and Practice. 2013;51(2):117–25.]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-637.

106. Crespo C, Brosa M, Galvan J, et al. Pharmacoeconomic analysis of Metoject in the treatment of rheumatoid arthritis in Spain. Reumatol Clin. 2010;6(4):203–11. DOI: 10.1016/j.reuma.2009.11.001. Epub 2010 Apr 24.

107. Schipper LG, Kievit W, den Broeder A, et al. Treatment strategy aiming at remission in early rheumatoid arthritis patients: starting with methotrexate monotherapy is cost-effctive. Rheumatology. 2011;50:1329–30. DOI: http://dx.doi.org/10.1093/rheumatology/ker084.

108. Fitzpatrick R, Scott DG, Keary I. Cost-minimization analysis of subcutaneous methotrexate versus biologic therapy for the treatment of patients with rheumatoid arthritis who have had an insufficient response or intolerance to oral methotrexate. Clin Rheumatol. 2013;32(11):1605–12. DOI: 10.1007/s10067-0132318-z. Epub 2013 Jul 9.

109. GUIPCAR Group. Update of the clinical practice guideline for the management of rheumatoid arthritis in Spain. Madrid (Spain): Spanish Society of Theumatology; 2011 Dec. 367 p.

110. Hassanzaden R, Nangan C, France J, et al. Subcutaneois methotrexate to cut costs. J Rheumatology. 2012;39:1764–5. DOI: 10.3899/jrheum.120091.

111. Morel J, Duzanski MO, Cantagrel A, et al. Prospective follow-up of tocilizumab treatment in 1100 patients with refractory rheumatoid arthritis: tolerance data from the french registry regate (registry–roactemra). Ann Rheum Dis. 2013;72 Suppl 3:456.

112. Hishitani Y, Ogata A, Shima Y, et al. Retention of tocilizumab and anti-tumour necrosis factor drugs in the treatment of rheumatoid arthritis. Scand J Rheumatol. 2013;42(4):253–9. DOI: 10.3109/03009742.2012.762037. Epub 2013 Mar 7.

113. Horak P, Skacelova M, Hejduk K, et al. Abatacept and its use in the treatment of rheumatoid arthritis (RA) in the Czech Republic – data from the ATTRA registry. Clin Rheumatol. 2013;32(10):1451–8. DOI: 10.1007/s10067-013-2303-6. Epub 2013 Jun 2.

114. Gottenberg JE, Ravaud P, Bardin T, et al. Risk factors for severe infections in patients with rheumatoid arthritis treated with rituximab in the autoimmunity and rituximab registry. Arthritis Rheum. 2010;62(9):2625–32. DOI: 10.1002/art.27555.

115. Godot S, Gottenberg JE, Paternotte S, et al. Safety of surgery after rituximab therapy in 133 patients with rheumatoid arthritis: Data from the AutoImmunity and Rituximab registry. Arthritis Care Res (Hoboken). 2013. DOI: 10.1002/acr.22056. [Epub ahead of print 10 Jun 2013].

116. Weinblatt ME, Schiff M, Valente R, et al. Head-to-head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: findings of a phase IIIb, multinational, prospective, randomized study. Arthritis Rheum. 2013;65(1):28–38. DOI: 10.1002/art.37711.

117. Emery P, Fleischmann R, Filipowicz-Sosnowska A, et al. The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double-blind, placebo-controlled, dose-ranging trial. Arthritis Rheum. 2006;54(5):1390–400. DOI: http://dx.doi.org/10.1002/art.21778.

118. Насонов ЕЛ. Применение ритуксимаба при ревматоидном артрите. В кн.: Анти-В-клеточная терапия в ревматологии: фокус на ритуксимаб. Насонов ЕЛ, редактор. Москва: ИМАПРЕСС; 2011. С. 55–93. [Nasonov EL. Primenenie rituksimaba pri revmatoidnom artrite. V kn.: Anti-B-kletochnaya terapiya v revmatologii: fokus na rituksimab. Nasonov EL, editor. Moscow: IMA-PRESS; 2011. P. 55–93.]

119. Buch MH, Smolen JS, Betteridge N, et al. Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2011;70(6):909–20. DOI: 10.1136/ard.2010.144998. Epub 2011 Mar 6.

120. Strangfeld A, Pattloch D, Herzer P, et al. Risk of cancer recurrence or new tumors in RA patients with prior malignancies treated with various biologic agents. Arhritis Rheum. 2013; (ACR 2013 Abstract online: https://ww2.rheumatology.org/apps/MyAnnualMeeting/Abstract/ 36584).

121. Bredermeier M, de Oliveira FK, Rocha CM. Lowversus highdoses rituximab for rheumatoid arthritis: a systemic review and meta-analysis. Artritis Care Res (Hoboken). 2013 Aug 07. DOI: 10.1002/ard.22116.

122. Yoo DH, Hrycaj P, Miranda P, et al. A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Ann Rheum Dis. 2013;72(10):1613–20. DOI: 10.1136/annrheumdis-2012-203090. Epub 2013 May 16.

123. Park W, Hrycaj P, Jeka S, et al. A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study. Ann Rheum Dis. 2013;72(10):1605–12. DOI: 10.1136/annrheumdis-2012-203091. Epub 2013 May 16.

124. Emery P, Sebba A, Huizinga TWJ. Biologic and oral diseasemodifying antirheumatic drug monotherapy in rheumatoid arthritis. Ann Rheum Dis. 2013;72(12):1897–904. DOI: 10.1136/annrheumdis-2013-203485.

125. Krieckaert CL, Nurmohamed MT, Wolbink GJ. Methotrexate reduces immunogenicity in adalimumab treated rheumatoid arthritis patients in a dose dependent manner. Ann Rheum Dis. 2012;71(11):1914–5. DOI: 10.1136/annrheumdis-2012-201544. Epub 2012 May 14.

126. Jones G, Sebba A, Gu J, et al. Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: the AMBITION study. Ann Rheum Dis. 2010;69(1):88–96. DOI: 10.1136/ard.2008.105197.

127. Nishimoto N, Hashimoto J, Miyasaka N, et al. Study of active controlled monotherapy used for rheumatoid arthritis, an IL-6 inhibitor (SAMURAI): evidence of clinical and radiographic benefit from an x ray reader-blinded randomised controlled trial of tocilizumab. Ann Rheum Dis. 2007;66(9):1162–7. DOI: http://dx.doi.org/10.1136/ard.2006.068064.

128. Burmester GR, Rigby W, van Vollenhoven R, et al. Tocilizumab (TCZ) in combination and monotherapy versus methotrexate (MTX) in MTX-naive patients (pts) with early rheumatoid arthritis (RA): clinical and radiographic outcomes from a randomised, placebo-controlled trial. Ann Rheum Dis. 2013;72(Suppl):OP041.

129. Smolen JS, Alethaha D. Interleukin-6 receptor inhibiton with tocilizumab and attaintmant remission: thew role of acute phase reactant. Arthritis Rheum. 2011;63(1):43–52. DOI: 10.1002/art.27740.

130. Takeuchi T, Kaneko Y, Atsumi T, et al. Adding tocilizumab or switching to tocilizumab monotherapy in RA patients with inadequate response to methotrexate: 24-week results from a randomized controlled study (SURPRISE study). Ann Rheum Dis. 2013;72 Suppl 3:62.

131. Dougados M, Kissel K, Sheeran T, et al. Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis. 2013;72(1):43–50. DOI: 10.1136/annrheumdis-2011-201282. Epub 2012 May 5.

132. Emery P, Kvien TK, Combe B, et al. Combination etanercept and methotrexate provides better disease control in very early (≤4 months) versus early rheumatoid arthritis (>4 months and <2 years): post hoc analyses from the COMET study. Ann Rheum Dis. 2012;71(6):989–92. DOI: 10.1136/annrheumdis-2011201066. Epub 2012 Mar 8.

133. Van Riel PL, Taggart AJ, Sany J, et al. Efficacy and safety of combination etanercept and methotrexate versus etanercept alone in patients with rheumatoid arthritis with an inadequate response to methotrexate: the ADORE study. Ann Rheum Dis. 2006;65(11):1478–83. DOI: http://dx.doi.org/10.1136/ard.2005.043299. Epub 2006 Feb 7.

134. Dougados M, Kissel K, Conaghan PG, et al. Clinical, radiographic, and immunogenetic effects after 1 year of tocilizumab (TCZ)-based treatment strategy with and without methotrexate (MTX) in RA: the ACT-RAY study. EULAR Congrsss THU0093. Berlin; 2012.

135. Soubrier M, Puechal X, Sibilia J, et al. Evaluation of two strategies (initial methotrexate monotherapy vs its combination with adalimumab) in management of early active rheumatoid arthritis: data from the GUEPARD trial. Rheumatology (Oxford). 2009;48(11):1429–34. DOI: 10.1093/rheumatology/kep261. Epub 2009 Sep 9.

136. Fleischmann R, van Vollenhoven RF, Smolen JS, et al. Long-term outcomes of early rheumatoid arthritis patients initiated with adalimumab plus methotrexate compared with methotrexate alone following a targeted treatment approach. Arthritis Rheum. 2012;64(Suppl):S335–6.

137. Smolen JS, Fleischmann RM, Emery P, et al. Treating rheumatoid arthritis to target: outcomes and predictors in early rheumatoid arthritis patients treated with adalimumab plus methotrexate, methotrexate alone, or methotrexate plus subsequent adalimumab. Arthritis Rheum. 2011;63(Suppl):S665.

138. O’Dell JR, Curtis JR, Mikuls T, et al. Validation of methotrexatefirst strategy in early poor prognosis rheumatoid arthritis. Results from a randomized, double-blind, 2-year trial. Arthritis Rheum. 2013, May 06. DOI 10.1002/art.38012.

139. 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.

140. Kavanaugh A, Emery P, Felischmann RM, et al. Withrawal of adalimumab in early rheumatoid arthritis patients who attained stable low disease activity with adalimumab plus methotrexate: results of a phase 4, double-blind, placebo-controlled trial. Rheumatology (Oxford). 2012;51 Suppl 3:iii27.

141. Emery P, Hammoudeh M, Fitzgerald O, et al. Assessing maintenance of remission with reduced dose etanercept plus methotrexate, methotrexate alone, or placebo in patients with early rheumatoid arthritis who achieved remission with etanercept and methotrextate: the PRIZE study. Ann Rheum Dis. 2013;72 Suppl 3:399.

142. Van Vollenhoven RF, Franck-Larsson K, Leirisalo-Repo M, et al. In rheumatoid arthritis patients with stable low disease activity on methotrexate plus etanercept, continuation of etanercept at 50 mg or 25 mg weekly are both clinically superior to discontinuation: results from a randomized, 3-arm, double-blind study. Ann Rheum Dis. 2013;72 Suppl 3:434.

143. Насонов ЕЛ, Александрова ЕН, Авдеева АС, Панасюк ЕЮ. Ингибиция интерлейкина 6 – новые возможности фармакотерапии иммуновоспалительных ревматических заболеваний. Научно-практическая ревматология. 2013;51(4):416–27. [Nasonov EL, Aleksandrova EN, Avdeeva AS, Panasyuk EY. Interleukin 6 inhibition: new possibilities of pharmacotherapy for immunoinflammatory rheumatic diseases. Rheumatology Science and Practice. 2013;51(4):416–27.]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-1254.

144. Насонов ЕЛ, Денисов ЛН, Станислав МЛ. Новые аспекты фармакотерапии ревматоидного артрита: ингибиторы малых молекул. Научно-практическая ревматология. 2012;50(2):66–75. [Nasonov EL, Denisov LN, Stanislav MI. New aspects of pharmacotherapy for rheumatoid arthritis: small molecule inhibitors. Rheumatology Science and Practice. 2012;50(2):66–75.]. DOI: http://dx.doi.org/10.14412/1995-44842012-1276.

145. Scott LJ. Tofacitinib: a review of its use in adult patients with rheumatoid arthritis. Drugs. 2013;73(8):857–74. DOI: 10.1007/s40265-013-0065-8.

146. European Medical Agency. Xeljanz. 2013. Available from: http://www.ema.europa.eu/ema/indexjsp?curl=pages/medicines/human/medicines/002542/smops/Negative/human_smop_ 000501jsp&mid=WC0b01ac058001d127 (accessed 25 May, 2014).

147. Committee for Medicinal Products for Human Use (CHMP). Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP). [Updated 2013 July 22–25]. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_ events/news/2013/07/news_detail_001851.jsp&mid=WC0b01ac0 58004d5c1.

148. Pfizer. Pfizer Receives CHMP Negative Opinion Regarding Marketing Authorization In Europe For Rheumatoid Arthritis Treatment XELJANZ (tofacitinib citrate). 2013. Available from: http://press.pfizer.com/press-release/pfizer-receives-chmp-negative-opinion-regarding-marketing-authorization-europe-rheumat (accessed 25 May 2013).

149. Van Vollenhoven RF, Fleischmann R, Cohen S, et al. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N Engl J Med. 2012;367(6):508–19. DOI: 10.1056/NEJMoa1112072.

150. Burmester GR, Blanco R, Charles-Schoeman C, et al. Tofacitinib (CP-690, 550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet. 2013;381(9865):451–60. DOI: 10.1016/S0140-6736(12)61424-X. Epub 2013 Jan 5.

151. Fleischmann R, Kremer J, Cush J, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N Engl J Med. 2012;367(6):495–507. DOI: 10.1056/NEJMoa1109071.

152. Van der Heijde D, Tanaka Y, Fleischmann R, et al. Tofacitinib (CP-690, 550) in patients with rheumatoid arthritis on methotrexate: 12-month data from a 24-month Phase 3 randomized radiographic study. Arthritis Rheum. 2013;65(3):559–70. DOI: 10.1002/art.37816.

153. Lee EB, Fleischmann RM, Hall S, et al. Radiographic, clinical and functional comparison of tofacitinib monotherapy versus methotrexate in methotrexate-nave patients with rheumatoid arthritis. Arthritis Rheum. 2012;64(Suppl):S1049.

154. Kawalec P, Mikrut A, Wisniewska N, Pilc A. The effectiveness of tofacitinib, a novel Janus kinase inhibitor. In the treatment of rheumatoid arthritis: a systemic review and metha-analysis. Clin Rheumatol. 2013;32(10):1414–24. DOI: 10.1007/s10067-0132329-9.

155. Salgado E, Maneiro JR, Carmona L, Gomez-Reino JJ. Safety profile of protein kinase inhibitors in rheumatoid arthritis: systemic review and meta-analysis. Ann Rheum Dis. 2013, Apr 18. DOI:10.1136/annrheumdis-2012-203116.

156. Winthrop KL, Baddley JW, Chen L, et al. Association between the initiation of anti-tumor necrosis factor therapy and the risk of herpes zoster. JAMA. 2013;309(9):887–95. DOI: 10.1001/jama.2013.1099.

157. Buch MH, Pavitt S, Parmar M, Emery P. Creative trial design in RA: optimizing patient outcomes. Nat Rev Rheumatol. 2013;9(3):183–94. DOI: 10.1038/nrrheum.2013.5. Epub 2013 Feb 5.

158. Yoshida K, Yoon-Kyoung Sung, Kavanaugh A, et al. Biologic discomtinuation studies: a systematic review of methods. Ann Rheum Dis. 2013, May 30. DOI: 10.1136/annrheumdis-2013203302.

159. Tanaka Y, Hirata S, Saleem B, Emery P. Discontinuation of biologics in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2013;31(4 Suppl 78):S22–7. Epub 2013 Oct 3.

160. Kavanaugh A, Smolen JS. The when and how of biologics withdrawal in rheumatoid arthritis: learning from large randomized controlled trials. Clin Exp Rheumatol. 2013; 31(4 Suppl 78):S19–21. Epub 2013 Oct 3.

161. Tanaka Y, Takeuchi T, Mimori T, et al. Discontinuation of infliximab after attaining low disease activity in patients with rheumatoid arthritis: RRR (remission induction by Remicade in RA) study. Ann Rheum Dis. 2010;69(7):1286–91. DOI: 10.1136/ard.2009.121491. Epub 2010 Apr 1.

162. Tanaka Y, Hirata S, Kubo S, et al. Discontinuation of adalimumab after achieving remission in patients with established rheumatoid arthritis: 1-year outcome of the HONOR study. Ann Rheum Dis. 2013, 25 May, DOI: 10.1136/annrheumdis-3013204016.

163. Chatzidionysiou K, Turesson C, Teleman A, et al. A multicenter, randomized, controlled, open-label pilot study of the feasibility of discontinuation of adalimumab in rheumatoid arthritis patients in stable clinical remission. Arthritis Rheum. 2012;64(Suppl):S336.

164. Smolen JS, Nash P, Durez P, et al. Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet. 2013;381(9870):918–29. DOI: 10.1016/S0140-6736(12)61811-X. Epub 2013 Jan 17.

165. Smolen JS, Emery P, Fleischmann R, et al. Adjustment of therapy in rheumatoid arthritis on the basis of achievement of stable low disease activity with adalimumab plus methotrexate or methotreate alone: the randomised controlled OPTIMA trial. Lancet. 2013 Oct 25. pii: S0140–6736(13)61751–1. DOI: 10.1016/S0140-6736(13)61751-1.

166. Klarenbeek NB, van der Kooij SM, Guler-Yuksel M, et al. Discontinuing treatment in patients with rheumatoid arthritis in sustained clinical remission: exploratory analyses from the BeSt study. Ann Rheum Dis. 2011;70(2):315–9. DOI: 10.1136/ard.2010.136556. Epub 2010 Nov 10.

167. Fautrel B, Gandjbakhch F, Foltz V, et al. Targeting the lowest efficacious dose for rheumatoid arthritis patients in remission: clinical and structural impact of a stepdown strategy trial based on progressive spacing of TNF-blocker injections (STRASS trial). Ann Rheum Dis. 2013;2 Suppl 3:72.

168. Nampei A, Nagayama Y. Discontinuation of tocilizumab after attaining remission in patients with rheumatoid arthritis. Ann Rheum Dis. 2013;72 Suppl 3:877.

169. Aguilar-Lozano L, Castillo-Ortiz JD, Vargas-Serafin C, et al. Sustained clinical remission and rate of relapse after tocilizumab withdeawal in patients with rheumatoid arthritis. J Rheumatol. 2013;40(7):1069–73. DOI: 10.3899/jrheum.121427.

170. Takeuchi T, Matsubara T, Ohta S, et al. Abatacept biologic-free remission study in established rheumatoid arthritis — ORION study. Ann Rheum Dis. 2013;72 Supple 3:613.

171. Batticciotto A, Varisco V, Antivalle M, et al. Dose reduction in patients with rheumatoid arthritis responding to the standard rituximab regimen. Ann Rheum Dis. 2013;72(Suppl):877.

172. Brocq O, Millasseau E, Albert C, et al. Effect of discontinuing TNFalpha antagonist therapy in patients with remission of rheumatoid arthritis. Joint Bone Spine. 2009;76(4):350–5. DOI: 10.1016/j.jbspin.2008.11.009. Epub 2009 Apr 11.

173. Ten Wolde S, Breedveld FC, Hermans J, et al. Randomised placebo-controlled study of stopping second-line drugs in rheumatoid arthritis. Lancet. 1996;347(8998):347–52. DOI: http://dx.doi.org/10.1016/S0140-6736(96)90535-8.

174. O’Mahony R, Richards A, Deighton C, et al. Withdrawal of DMARDs in patients with Rheumatoid Arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2010;69(10):1823–6. DOI: 10.1136/ard.2008.105577. Epub 2009 Feb 17.

175. Van der Woude D, Visser K, Klarenbeek NB, et al. Sustained drug-free remission in rheumatoid arthritis after DAS-driven or non-DAS-driven therapy: a comparison of two cohort studies. Rheumatology (Oxford). 2012;51(6):1120–8. DOI: 10.1093/rheumatology/ker516. Epub 2012 Feb 15.

176. Gonzalez A, Maradit KH, Crowson CS, et al. Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients? Ann Rheum Dis. 2008;67(1):64–9. DOI: http://dx.doi.org/10.1136/ard.2006.059980. Epub 2007 May 21.

177. Baecklund E, Iliadou A, Askling J, et al. Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum. 2006;54(3):692–701. DOI: http://dx.doi.org/10.1002/art.21675.

178. Choi HK, Hernan 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/S0140-6736(02)08213-2.

179. Westlake SL, Colebatch AN, Baird J, et al. The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review. Rheumatology (Oxford). 2010;49(2):295–307. DOI: 10.1093/rheumatology/kep366. Epub 2009 Nov 27.

180. Westlake SL, Colebatch AN, Baird J, et al. Tumour necrosis factor antagonists and the risk of cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review. Rheumatology (Oxford). 2011;50(3):518–31. DOI: 10.1093/rheumatology/keq316. Epub 2010 Nov 11.

181. Kavanaugh A. Guidelines for RA therapy-avoiding hamartia. Nat Rev Rheumatol. 2010;6(9):505–6. DOI: 10.1038/nrrheum.2010.138.

182. Aletaha D, Funovits J, Breedveld FC, et al. Rheumatoid arthritis joint progression in sustained remission is determined by disease activity levels preceding the period of radiographic assessment. Arthritis Rheum. 2009;60(5):1242–9. DOI: 10.1002/art.24433.

183. Kelly C, Malik S, Gerting H, Hamilton J. Identification and treatment of comorbidity in patients with rheumatoid arthritis. Int J Clin Rheumatol. 2012;8:557–68. DOI: http://dx.doi.org/10.2217/ijr.13.49


Для цитирования:


Насонов Е.Л., Каратеев Д.Е., Чичасова Н.В. Рекомендации EULAR по лечению ревматоидного артрита – 2013: общая характеристика и дискуссионные проблемы. Научно-практическая ревматология. 2015;53(5s):18-31. https://doi.org/10.14412/1995-4484-2015-18-31

For citation:


Nasonov E.L., Karateev D.E., Chichasova N.V. EULAR RECOMMENDATIONS FOR THE TREATMENT OF RHEUMATOID ARTHRITIS – 2013: GENERAL CHARACTERISTICS AND DISPUTABLE PROBLEMS. Rheumatology Science and Practice. 2015;53(5s):18-31. (In Russ.) https://doi.org/10.14412/1995-4484-2015-18-31

Просмотров: 478


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)