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Научно-практическая ревматология

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Опыт применения тоцилизумаба у больных ревматоидным артритом (по данным многоцентрового исследования ЛОРНЕТ)

https://doi.org/10.14412/1995-4484-2013-635

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Аннотация

Цель оценить изменение качества жизни пациентов с ревматоидным артритом (РА) при добавлении к терапии базисными противовоспалительными препаратами (БПВП) тоцилизумаба (ТЦЗ), а также изучить эффективность и безопасность терапии ТЦЗ у больных РА с неадекватным ответом на предшествующее лечение БПВП. Материал и методы. Обследован 201 больной РА. Все пациенты получили по шесть инфузий ТЦЗ в дозе 8 мг/кг внутривенно с интервалом в 4 нед на фоне стабильной терапии БПВП и глюкокортикоидами. Для оценки эффективности терапии ТЦЗ использовали критерии EULAR, ACR, а также индексы активности SDAI и CDAI. Ремиссию заболевания оценивали по критериям EULAR. Результаты и обсуждение. До начала терапии ТЦЗ значения (медиана [25-й; 75-й перцентили]) индексов DAS28 6,8 [6,1; 7,4], SDAI 41,8 [34,6; 53,7] и CDAI 39,2 [31,4; 49,5] соответствовали высокой активности РА. К 4-й неделе терапии ТЦЗ отмечено снижение уровней DAS28 4,6 [3,8; 5,4], SDAI 24,6 [17,8; 33,4] и CDAI 23,6 [17,5; 32,0], сохранявшееся до 24-й недели (р<0,01). К 24-й неделе терапии ТЦЗ у 133 (70,4%) больных наблюдался хороший эффект по критериям EULAR, у 54 (28,6%) пациентов удовлетворительный; эффект отсутствовал у 2 (1,1%) больных. Эффект по ACR20/50/70 регистрировался соответственно у 89,1/70,6/44,3% больных. Ремиссия по критериям EULAR была достигнута у 51,3% больных, по индексу SDAI у 21,4%. Наблюдалось улучшение функционального состояния, а также качества жизни по опросникам EQ-5D и SF-36. Нормализация уровня С-реактивного белка и СОЭ регистрировалась через 4 нед после первой инфузии препарата и сохранялась до 24-й недели лечения. Заключение. Таким образом, анализ данных российского исследования убедительно свидетельствует об эффективности и хорошей переносимости ТЦЗ при тяжелом РА, резистентном к стандартной терапии БПВП.

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Для цитирования:


Панасюк Е.Ю., Amirdzhanova V.N., Avdeyeva A.S., Лучихина Е.Л., Александрова Е.Н., Новиков А.А., Насонов Е.Л. Опыт применения тоцилизумаба у больных ревматоидным артритом (по данным многоцентрового исследования ЛОРНЕТ). Научно-практическая ревматология. 2013;51(2):104-110. https://doi.org/10.14412/1995-4484-2013-635

For citation:


Panasyuk E.Y., Amirdzhanova V.N., Avdeyeva A.S., Luchikhina E.L., Aleksandrova E.N., Novikov A.A., Nasonov E.L. Experience with tocilizumab in patients with rheumatoid arthritis (according to the data of the LORNET multicenter trial). Rheumatology Science and Practice. 2013;51(2):104-110. (In Russ.) https://doi.org/10.14412/1995-4484-2013-635

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