vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v12i2.617vsp-343Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESРетроспективный анализ эффективности и безопасности тоцилизумаба у больных тяжелым системным ювенильным идиопатическим артритом: 12 месяцев наблюденияRetrospective Analysis of Efficacy and Safety of Tocilizumab Treatment in Children with Severe Systemic Juvenile Idiopathic Arthritis: 12-month Follow-upБарановА. А.BaranovA. A.baranov@nczd.ruАлексееваИ. И.AlexeevaE. I.

Contacts: Alekseyeva Yekaterina Iosifovna, PhD, MD, professor, Head of Rheumatological Department, National Center of Children’s Health, Russian Academy of Medical Sciences, Dean of Pediatric Faculty, I.M. Sechenov First Moscow State Medical University Address: 119991, Moscow, Lomonosovskiy Prospect, 2, bldg. 1, Tel.: (499) 134-02-97, e-mail: alekatya@yandex.ru

alekatya@ya.ruДенисоваР. В.DenisovaR. V.alekatya@ya.ruВалиеваС. И.ValievaS. I.alekatya@ya.ruБзароваТ. М.BzarovaT. M.alekatya@ya.ruИсаеваК. Б.IsaevaK. B.alekatya@ya.ruСлепцоваТ. В.SteptsovaT. V.alekatya@ya.ruМитенкоЕ. В.MitenkoE. V.alekatya@ya.ruЧистяковаЕ. Г.ChistyakovaE. G.alekatya@ya.ruФетисоваА. Н.FetisovaA. N.alekatya@ya.ruНаучный центр здоровья детей РАМН, Москва; Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияScientific Centre of Children Health, RAMS, Moscow; I.M. Sechenov First Moscow State Medical UniversityRussian FederationНаучный центр здоровья детей РАМН, МоскваРоссияScientific Centre of Children Health, RAMS, MoscowRussian Federation201319032013122Вопросы современной педиатрии2634Copyright © Баранов А.А., Алексеева И.И., Денисова Р.В., Валиева С.И., Бзарова Т.М., Исаева К.Б., Слепцова Т.В., Митенко Е.В., Чистякова Е.Г., Фетисова А.Н., 20132013Баранов А.А., Алексеева И.И., Денисова Р.В., Валиева С.И., Бзарова Т.М., Исаева К.Б., Слепцова Т.В., Митенко Е.В., Чистякова Е.Г., Фетисова А.Н.Baranov A.A., Alexeeva E.I., Denisova R.V., Valieva S.I., Bzarova T.M., Isaeva K.B., Steptsova T.V., Mitenko E.V., Chistyakova E.G., Fetisova A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/343Цель исследования

Цель исследования: провести ретроспективный анализ эффективности и безопасности лечения тоцилизумабом детей с тяжелым рефрактерным системным ювенильным идиопатическим артритом. Участники и методы исследования: результаты лечения оценивали у 75 пациентов (35 девочек и 40 мальчиков) в возрасте 8,8 (6; 12) лет с тяжелым системным ювенильным идиопатическим артритом, рефрактерным к стандартной иммуносупрессивной терапии, со средней длительностью болезни до назначения тоцилизумаба 3,2 (1,9; 5,2) года. Диагноз устанавливали на основании критериев ILAR. Всем больным проводилось стандартное клинико-лабораторное обследование. Эффективность проводимой терапии оценивали по педиатрическим критериям улучшения Американской коллегии ревматологов. Целевыми показателями эффективности проводимой терапии считали частоту достижения стадии неактивной болезни и лекарственной ремиссии заболевания. Результаты: через 6 мес лечения статус неактивной болезни был зарегистрирован у 64%, а через 12 мес — у 73% пациентов. Нежелательные явления выражались в виде инфекций легкой и средней степени тяжести, а также изменений со стороны лабораторных показателей: лейко- и нейтропенией, повышением активности аминотрансфераз. Выводы: тоцилизумаб высокоэффективен у больных самым тяжелым системным вариантом ювенильного артрита, рефрактерным к лечению глюкокортикоидами, метотрексатом, циклоспорином, а также к комбинированной иммуносупрессивной, анти-ФНО и анти-В-клеточной терапии.

 

 

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The authors declare that there are no conflicts of interest present.