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Научно-практическая ревматология

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Первое российское стратегическое исследование фармакотерапии ревматоидного артрита (РЕМАРКА)

https://doi.org/10.14412/1995-4484-2013-637

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Аннотация

Международные рекомендации «Treat to target» (T2T) «Лечение до достижения цели» подчеркивают, что важнейшее значение для успеха терапии ревматоидного артрита (РА) имеет стратегия лечения. Очевидно, что для оценки эффективности такого подхода требуются специальные стратегические исследования с «адаптивным» дизайном, которые существенно отличаются от классических рандомизированных клинических исследований и находятся гораздо ближе к клинической практике. До настоящего времени имеются лишь единичные публикации по практическому применению рекомендаций Т2Т, существуют проблема выбора критериев эффективности, а также ряд других важных проблем, связанных с внедрением этих рекомендаций. Российское исследование РЕМАРКА призвано ответить на эти вопросы. Дизайн исследования РЕМАРКА представляет собой практическую адаптацию стратегии Т2Т к лечению больных активным ранним РА и РА в развернутой стадии, имеющих факторы неблагоприятного прогноза, с помощью метотрексата в подкожной форме и генно-инженерных биологических препаратов (ГИБП). Предварительный анализ показывает, что терапия по протоколу РЕМАРКА успешна у большинства пациентов. Достигнута высокая частота низкой активности РА и ремиссии при монотерапии подкожной формой метотрексата. Пациенты, нуждающиеся в подключении ГИБП, возможно, изначально являются более резистентными к терапии. Больные ранним РА имеют более высокие шансы на успешное лечение по принципам Т2Т, чем больные развернутым РА.

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Для цитирования:


Каратеев Д.Е., Лучихина Е.Л., Муравьев Ю.В., Демидова Н.В., Grineva G.I., Новикова Д.С., Александрова Е.Н., Новиков А.А., Смирнов А.В., Волков А.В., Avdeyeva A.S., Lopareva E.V., Олюнин Ю.А., Лукина Г.В., Попкова Т.В., Насонов Е.Л. Первое российское стратегическое исследование фармакотерапии ревматоидного артрита (РЕМАРКА). Научно-практическая ревматология. 2013;51(2):117-125. https://doi.org/10.14412/1995-4484-2013-637

For citation:


Karateev D.E., Luchikhina E.L., Muravyev Y.V., Demidova N.V., Grineva G.I., Novikova D.S., Aleksandrova E.N., Novikov A.A., Smirnov A.V., Volkov A.V., Avdeyeva A.S., Lopareva E.V., Olyunin Y.A., Lukina G.V., Popkova T.V., Nasonov E.L. The first Russian strategic study of pharmacotherapy for rheumatoid arthritis (REMARCA). Rheumatology Science and Practice. 2013;51(2):117-125. (In Russ.) https://doi.org/10.14412/1995-4484-2013-637

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