ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ ЧЕЛОВЕЧЕСКИХ МОНОКЛОНАЛЬНЫХ АНТИТЕЛ К ФНО α У ДЕТЕЙ С ЮВЕНИЛЬНЫМ ИДИОПАТИЧЕСКИМ АРТРИТОМ ПРИ ПЕРВИЧНОЙ И ВТОРИЧНОЙ НЕЭФФЕКТИВНОСТИ ДРУГИХ ГЕННО-ИНЖЕНЕРНЫХ БИОЛОГИЧЕСКИХ ПРЕПАРАТОВ

Лечение ювенильного идиопатического артрита — одна из серьезных проблем детской ревматологии. В статье представлены результаты ретроспективного обсервационного исследования эффективности и безопасности адалимумаба (моноклональные человеческие антитела к фактору некроза опухоли α) в реальной клинической практике у пациентов с ювенильным идиопатическим артритом при первичной и вторичной неэффективности других генно-инженерных биологических препаратов: у 48 из 56 детей — инфликсимаба, у 2 — этанерцепта, у 5 — ритуксимаба, у 1 — абатацепта. Адалимумаб назначали подкожно, в дозе 40 мг, 1 раз в 2 нед. Эффективность оценивали по критериям АКР_педи. Через 4 нед лечения у 100% пациентов отмечено 30% улучшение, у 80% — 50%, у 60% — 70%. Через 24 нед лечения 30% улучшение зарегистрировано у 100% (56) детей, 50% — у 91% (51), 70% — у 74% (41) пациентов. Стадия неактивной болезни была зафиксирована через 24 нед у 55% детей, через год — у 85% пациентов; ремиссия достигнута у 55% больных. Тяжелых нежелательных явлений не отмечено. Полученные результаты демонстрируют, что адалимумаб эффективен у больных ювенильным идиопатическим артритом в случае первичной и вторичной резистентности к другим биологическим агентам.

Ключевые слова: дети, ювенильный идиопатический артрит, адалимумаб, лечение, блокаторы фактора некроза опухоли α, резистентность, генно-инженерные препараты.

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