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Снижение потребности в глюкокортикоидах на фоне терапии генно-инженерными биологическими препаратами и ингибиторами янус-киназ при ревматоидном артрите: данные реальной клинической практики
Снижение потребности в глюкокортикоидах на фоне терапии генно-инженерными биологическими препаратами и ингибиторами янус-киназ при ревматоидном артрите: данные реальной клинической практики
Потапова А.С., Каратеев А.Е., Полищук Е.Ю., Филатова Е.С., Амирджанова В.Н., Лила А.М. Снижение потребности в глюкокортикоидах на фоне терапии генно-инженерными биологическими препаратами и ингибиторами янус-киназ при ревматоидном артрите: данные реальной клинической практики. Терапевтический архив. 2024;96(5):465–470. DOI: 10.26442/00403660.2024.05.202701
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
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Аннотация
Обоснование. Актуальные клинические рекомендации по лечению ревматоидного артрита (РА) указывают на необходимость снижения использования глюкокортикоидов (ГК) в связи с высоким риском осложнений на фоне приема этих препаратов.
Цель. Определить частоту отмен и снижения дозы ГК на фоне активной терапии РА в реальной клинической практике.
Материалы и методы. Исследуемую группу составили 303 пациента с РА, достоверным по критериям ACR/EULAR (женщины – 79,9%, возраст – 52,8±13,3 года, длительность болезни – 9 [4; 16] лет, DAS-28-СРБ – 4,9±1,0, серопозитивность по ревматоидному фактору – 77,4%, по антителам к циклическому цитруллиновому пептиду – 70,3%), которым в связи с обострением заболевания и неэффективностью предшествующего лечения назначена или изменена терапия синтетическими базисными противовоспалительными препаратами (сБПВП), генно-инженерными биологическими препаратами (ГИБП) или ингибиторами янус-киназ (иJAK). Все пациенты исходно получали ГК (7,7±3,8 мг/сут в эквиваленте преднизолона). После коррекции терапии 42,9% пациентов получали метотрексат, 27,6% – лефлуномид, 29,5% – сульфасалазин, гидроксихлорохин или комбинацию сБПВП, 63,7% – ГИБП, 7,2% – иJAK. Оценивалась потребность в приеме ГК по данным телефонного опроса, проведенного через 6 мес после начала наблюдения.
Результаты. Телефонный опрос удалось провести у 274 (90,4%) лиц. Отмечено достоверное снижение интенсивности боли (числовая рейтинговая шкала – ЧРШ 0–10) с 6,3±1,4 до 4,3±2,4 (p<0,001), усталости (ЧРШ) – с 6,7±2,3 до 5,2±2,1 (p<0,001), функциональных нарушений (ЧРШ) – с 5,4±2,1 до 3,9±2,0 (p<0,001). Положительный индекс PASS (состояние симптомов, приемлемое для пациентов) отмечен у 139 (50,7%) пациентов. Отмена ГК наблюдалась у 19,7%, снижение дозы – у 25,9%, сохранение прежней дозы – у 42,7%, повышение дозы – у 11,7%.
Заключение. На фоне активной терапии РА, включающей комбинацию сБПВП с ГИБП или иJAK, через 6 мес удалось добиться полной отмены или снижения дозы ГК менее чем у 1/2 (45,6%) пациентов.
Ключевые слова: ревматоидный артрит, базисные противовоспалительные препараты, генно-инженерные биологические препараты, ингибиторы янус-киназ, глюкокортикоиды, отмена, снижение дозы
Aim. To determine the frequency of GC cancellations and dose reductions in real clinical practice, while taking into account active RA therapy.
Materials and methods. The study group consisted of 303 patients with RA reliable according to ACR/EULAR criteria (women 79.9%, age 52.8±13.3, disease duration 9 [4; 16] years, DAS-28-CRP 4.9±1.0, RF seropositivity 77.4%, ACPA seropositivity 70.3%), who were prescribed or changed therapy with disease-modifying antirheumatic drugs (DMARDs), biologic disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (iJAK) due to disease exacerbation and ineffectiveness of previous treatment. All patients initially received GC (7.7±3.8 mg/day equivalent of prednisolone). After adjustment of therapy, 42.9% of patients received methotrexate, 27.6% leflunomide, 2.5% sulfasalazine, hydroxychloroquine, or a combination with an Non-steroidal anti-inflammatory drugs, 63.7% bDMARDs, and 7.2% iJAK. The need for GC intake was assessed by a telephone survey conducted 6 months after the start of follow-up.
Results. Telephone survey was possible in 274 (90.4%) persons. There was a significant decrease in pain intensity (numerical rating scale, NRS 0–10) from 6.3±1.4 to 4.3±2.4 (p<0.001), fatigue (NRS) from 6.7±2.3 to 5.2±2.1 (p<0.001), and functional impairment (NRS) from 5.4±2.1 to 3.9±2.0 (p<0.001). A positive PASS index (symptom status acceptable to patients) was noted in 139 (50.7%) patients. GC cancellation was noted in 19.7%, dose reduction in 25.9%, maintaining the same dose in 42.7%, and dose increase in 11.7%.
Conclusion. Against the background of intensive RA therapy, including combination of DMARDs with bDMARDs or iJAK, complete withdrawal or reduction of GC dose was achieved in less than half (45.6%) of patients after 6 months.
Keywords: rheumatoid arthritis, disease-modifying antirheumatic drugs, biologic disease-modifying antirheumatic drugs, Janus kinase inhibitor, glucocorticoids, withdrawal, dose reduction
Цель. Определить частоту отмен и снижения дозы ГК на фоне активной терапии РА в реальной клинической практике.
Материалы и методы. Исследуемую группу составили 303 пациента с РА, достоверным по критериям ACR/EULAR (женщины – 79,9%, возраст – 52,8±13,3 года, длительность болезни – 9 [4; 16] лет, DAS-28-СРБ – 4,9±1,0, серопозитивность по ревматоидному фактору – 77,4%, по антителам к циклическому цитруллиновому пептиду – 70,3%), которым в связи с обострением заболевания и неэффективностью предшествующего лечения назначена или изменена терапия синтетическими базисными противовоспалительными препаратами (сБПВП), генно-инженерными биологическими препаратами (ГИБП) или ингибиторами янус-киназ (иJAK). Все пациенты исходно получали ГК (7,7±3,8 мг/сут в эквиваленте преднизолона). После коррекции терапии 42,9% пациентов получали метотрексат, 27,6% – лефлуномид, 29,5% – сульфасалазин, гидроксихлорохин или комбинацию сБПВП, 63,7% – ГИБП, 7,2% – иJAK. Оценивалась потребность в приеме ГК по данным телефонного опроса, проведенного через 6 мес после начала наблюдения.
Результаты. Телефонный опрос удалось провести у 274 (90,4%) лиц. Отмечено достоверное снижение интенсивности боли (числовая рейтинговая шкала – ЧРШ 0–10) с 6,3±1,4 до 4,3±2,4 (p<0,001), усталости (ЧРШ) – с 6,7±2,3 до 5,2±2,1 (p<0,001), функциональных нарушений (ЧРШ) – с 5,4±2,1 до 3,9±2,0 (p<0,001). Положительный индекс PASS (состояние симптомов, приемлемое для пациентов) отмечен у 139 (50,7%) пациентов. Отмена ГК наблюдалась у 19,7%, снижение дозы – у 25,9%, сохранение прежней дозы – у 42,7%, повышение дозы – у 11,7%.
Заключение. На фоне активной терапии РА, включающей комбинацию сБПВП с ГИБП или иJAK, через 6 мес удалось добиться полной отмены или снижения дозы ГК менее чем у 1/2 (45,6%) пациентов.
Ключевые слова: ревматоидный артрит, базисные противовоспалительные препараты, генно-инженерные биологические препараты, ингибиторы янус-киназ, глюкокортикоиды, отмена, снижение дозы
________________________________________________
Aim. To determine the frequency of GC cancellations and dose reductions in real clinical practice, while taking into account active RA therapy.
Materials and methods. The study group consisted of 303 patients with RA reliable according to ACR/EULAR criteria (women 79.9%, age 52.8±13.3, disease duration 9 [4; 16] years, DAS-28-CRP 4.9±1.0, RF seropositivity 77.4%, ACPA seropositivity 70.3%), who were prescribed or changed therapy with disease-modifying antirheumatic drugs (DMARDs), biologic disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (iJAK) due to disease exacerbation and ineffectiveness of previous treatment. All patients initially received GC (7.7±3.8 mg/day equivalent of prednisolone). After adjustment of therapy, 42.9% of patients received methotrexate, 27.6% leflunomide, 2.5% sulfasalazine, hydroxychloroquine, or a combination with an Non-steroidal anti-inflammatory drugs, 63.7% bDMARDs, and 7.2% iJAK. The need for GC intake was assessed by a telephone survey conducted 6 months after the start of follow-up.
Results. Telephone survey was possible in 274 (90.4%) persons. There was a significant decrease in pain intensity (numerical rating scale, NRS 0–10) from 6.3±1.4 to 4.3±2.4 (p<0.001), fatigue (NRS) from 6.7±2.3 to 5.2±2.1 (p<0.001), and functional impairment (NRS) from 5.4±2.1 to 3.9±2.0 (p<0.001). A positive PASS index (symptom status acceptable to patients) was noted in 139 (50.7%) patients. GC cancellation was noted in 19.7%, dose reduction in 25.9%, maintaining the same dose in 42.7%, and dose increase in 11.7%.
Conclusion. Against the background of intensive RA therapy, including combination of DMARDs with bDMARDs or iJAK, complete withdrawal or reduction of GC dose was achieved in less than half (45.6%) of patients after 6 months.
Keywords: rheumatoid arthritis, disease-modifying antirheumatic drugs, biologic disease-modifying antirheumatic drugs, Janus kinase inhibitor, glucocorticoids, withdrawal, dose reduction
Полный текст
Список литературы
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11. Alten R, Nüßlein H, Galeazzi M, et al. Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study. RMD Open. 2016;2(1):e000228. DOI:10.1136/rmdopen-2015-000228
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14. Inoue M, Kanda H, Tateishi S, Fujio K. Factors associated with discontinuation of glucocorticoids after starting biological disease-modifying antirheumatic drugs in rheumatoid arthritis patients. Mod Rheumatol. 2020;30(1):58-63. DOI:10.1080/14397595.2018.1553264
15. Suzuki M, Kojima T, Takahashi N, et al. Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study. Mod Rheumatol. 2021;31(4):796-802. DOI:10.1080/14397595.2021.1879428
16. Spinelli FR, Garufi C, Mancuso S, et al. Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib. Sci Rep. 2023;13(1):15537. DOI:10.1038/s41598-023-42371-z
17. Wallace BI, England BR, Baker JF, et al. Lowering Expectations: Glucocorticoid Tapering Among Veterans With Rheumatoid Arthritis Achieving Low Disease Activity on Stable Biologic Therapy. ACR Open Rheumatol. 2023;5(9):437-42. DOI:10.1002/acr2.11584
18. Xie W, Huang H, Zhang Z. Dynamic Characteristics and Predictive Profile of Glucocorticoids Withdrawal in Rheumatoid Arthritis Patients Commencing Glucocorticoids with csDMARD: A Real-World Experience. Rheumatol Ther. 2023;10(2):405-19. DOI:10.1007/s40744-022-00527-9
19. Lauper K, Mongin D, Bergstra SA, et al. Evaluation and comparison of oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. 2023:105671. DOI:10.1016/j.jbspin.2023.105671
20. Гордеев А.В., Матьянова Е.В., Галушко Е.А. Длительный прием глюкокортикоидов больными активным ревматоидным артритом: терапевтический «стоп-кадр». Терапевтический архив. 2023;95(5):380-5 [Gordeev AV, Matyanova EV, Galushko EA. Long-term use of glucocorticoids in patients with active rheumatoid arthritis: therapeutic "freeze frame". Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(5):380-5 (in Russian)]. DOI:10.26442/00403660.2023.05.202196
21. Crowson LP, Davis JM 3rd, Hanson AC, et al. Time Trends in Glucocorticoid Use in Rheumatoid Arthritis During the Biologics Era: 1999-2018. Semin Arthritis Rheum. 2023;61:152219. DOI:10.1016/j.semarthrit.2023.152219
22. Adami G, Fassio A, Rossini M, et al. Tapering glucocorticoids and risk of flare in rheumatoid arthritis on biological disease-modifying antirheumatic drugs (bDMARDs). RMD Open. 2023;9(1):e002792. DOI:10.1136/rmdopen-2022-002792
23. Burmester GR, Buttgereit F, Bernasconi C, et al. Continuing versus tapering glucocorticoids after achievement of low disease activity or remission in rheumatoid arthritis (SEMIRA): a double-blind, multicentre, randomised controlled trial. Lancet. 2020;396(10246):267-76. DOI:10.1016/S0140-6736(20)30636-X
2. Cutolo M, Shoenfeld Y, Bogdanos DP, et al. To treat or not to treat rheumatoid arthritis with glucocorticoids? A reheated debate. Autoimmun Rev. 2023:103437. DOI:10.1016/j.autrev.2023.103437
3. Hetland ML, Haavardsholm EA, Rudin A, et al. Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial. BMJ. 2020;371:m4328. DOI:10.1136/bmj.m4328
4. Boers M, Hartman L, Opris-Belinski D, et al. Low dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: the pragmatic randomised, double-blind placebo-controlled GLORIA trial. Ann Rheum Dis. 2022;81(7):925-36. DOI:10.1136/annrheumdis-2021-221957
5. Aronova EA, Belov BS, Gridneva GI. Revisiting the question of the safety of glucocorticoids use of in the treatment of rheumatoid arthritis. Modern Rheumatology Journal. 2023;17(3):89-95 (in Russian). DOI:10.14412/1996-7012-2023-3-89-95
6. Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023;82(1):3-18. DOI:10.1136/ard-2022-223356
7. Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2021;73(7):1108-23. DOI:10.1002/art.41752
8. Rheumatoid arthritis. Clinical recommendations. Available at: https://cr.minzdrav.gov.ru/schema/250_2. Accessed: 28.03.2024 (in Russian).
9. Pincus T, Cutolo M. Clinical trials documenting the efficacy of low-dose glucocorticoids in rheumatoid arthritis. Neuroimmunomodulation. 2015;22(1-2):46-50. DOI:10.1159/000362734
10. Nilsson AC, Christensen AF, Junker P, Lindegaard HM. Tumour necrosis factor-α inhibitors are glucocorticoid-sparing in rheumatoid arthritis. Dan Med Bull. 2011;58(4):A4257.
11. Alten R, Nüßlein H, Galeazzi M, et al. Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study. RMD Open. 2016;2(1):e000228. DOI:10.1136/rmdopen-2015-000228
12. Duquenne C, Wendling D, Sibilia J, et al. Glucocorticoid-sparing effect of first-year anti-TNFα treatment in rheumatoid arthritis (CORPUS Cohort). Clin Exp Rheumatol.
2017;35(4):638-46.
13. Fleischmann R, Wollenhaupt J, Cohen S, et al. Effect of Discontinuation or Initiation of Methotrexate or Glucocorticoids on Tofacitinib Efficacy in Patients with Rheumatoid Arthritis: A Post Hoc Analysis. Rheumatol Ther. 2018;5(1):203-14. DOI:10.1007/s40744-018-0093-7
14. Inoue M, Kanda H, Tateishi S, Fujio K. Factors associated with discontinuation of glucocorticoids after starting biological disease-modifying antirheumatic drugs in rheumatoid arthritis patients. Mod Rheumatol. 2020;30(1):58-63. DOI:10.1080/14397595.2018.1553264
15. Suzuki M, Kojima T, Takahashi N, et al. Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study. Mod Rheumatol. 2021;31(4):796-802. DOI:10.1080/14397595.2021.1879428
16. Spinelli FR, Garufi C, Mancuso S, et al. Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib. Sci Rep. 2023;13(1):15537. DOI:10.1038/s41598-023-42371-z
17. Wallace BI, England BR, Baker JF, et al. Lowering Expectations: Glucocorticoid Tapering Among Veterans With Rheumatoid Arthritis Achieving Low Disease Activity on Stable Biologic Therapy. ACR Open Rheumatol. 2023;5(9):437-42. DOI:10.1002/acr2.11584
18. Xie W, Huang H, Zhang Z. Dynamic Characteristics and Predictive Profile of Glucocorticoids Withdrawal in Rheumatoid Arthritis Patients Commencing Glucocorticoids with csDMARD: A Real-World Experience. Rheumatol Ther. 2023;10(2):405-19. DOI:10.1007/s40744-022-00527-9
19. Lauper K, Mongin D, Bergstra SA, et al. Evaluation and comparison of oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. 2023:105671. DOI:10.1016/j.jbspin.2023.105671
20. Gordeev AV, Matyanova EV, Galushko EA. Long-term use of glucocorticoids in patients with active rheumatoid arthritis: therapeutic "freeze frame". Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(5):380-5 (in Russian). DOI:10.26442/00403660.2023.05.202196
21. Crowson LP, Davis JM 3rd, Hanson AC, et al. Time Trends in Glucocorticoid Use in Rheumatoid Arthritis During the Biologics Era: 1999-2018. Semin Arthritis Rheum. 2023;61:152219. DOI:10.1016/j.semarthrit.2023.152219
22. Adami G, Fassio A, Rossini M, et al. Tapering glucocorticoids and risk of flare in rheumatoid arthritis on biological disease-modifying antirheumatic drugs (bDMARDs). RMD Open. 2023;9(1):e002792. DOI:10.1136/rmdopen-2022-002792
23. Burmester GR, Buttgereit F, Bernasconi C, et al. Continuing versus tapering glucocorticoids after achievement of low disease activity or remission in rheumatoid arthritis (SEMIRA): a double-blind, multicentre, randomised controlled trial. Lancet. 2020;396(10246):267-76. DOI:10.1016/S0140-6736(20)30636-X
2. Cutolo M, Shoenfeld Y, Bogdanos DP, et al. To treat or not to treat rheumatoid arthritis with glucocorticoids? A reheated debate. Autoimmun Rev. 2023:103437. DOI:10.1016/j.autrev.2023.103437
3. Hetland ML, Haavardsholm EA, Rudin A, et al. Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial. BMJ. 2020;371:m4328. DOI:10.1136/bmj.m4328
4. Boers M, Hartman L, Opris-Belinski D, et al. Low dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: the pragmatic randomised, double-blind placebo-controlled GLORIA trial. Ann Rheum Dis. 2022;81(7):925-36. DOI:10.1136/annrheumdis-2021-221957
5. Аронова Е.С., Белов Б.С., Гриднева Г.И. К вопросу о безопасности применения глюкокортикоидов в терапии ревматоидного артрита. Современная ревматология. 2023;17(3):89-95 [Aronova EA, Belov BS, Gridneva GI. Revisiting the question of the safety of glucocorticoids use of in the treatment of rheumatoid arthritis. Modern Rheumatology Journal. 2023;17(3):89-95 (in Russian)]. DOI:10.14412/1996-7012-2023-3-89-95
6. Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023;82(1):3-18. DOI:10.1136/ard-2022-223356
7. Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2021;73(7):1108-23. DOI:10.1002/art.41752
8. Ревматоидный артрит. Клинические рекомендации. Режим доступа: https://cr.minzdrav.gov.ru/schema/250_2. Ссылка активна на 28.03.2024 [Rheumatoid arthritis. Clinical recommendations. Available at: https://cr.minzdrav.gov.ru/schema/250_2. Accessed: 28.03.2024 (in Russian)].
9. Pincus T, Cutolo M. Clinical trials documenting the efficacy of low-dose glucocorticoids in rheumatoid arthritis. Neuroimmunomodulation. 2015;22(1-2):46-50. DOI:10.1159/000362734
10. Nilsson AC, Christensen AF, Junker P, Lindegaard HM. Tumour necrosis factor-α inhibitors are glucocorticoid-sparing in rheumatoid arthritis. Dan Med Bull. 2011;58(4):A4257.
11. Alten R, Nüßlein H, Galeazzi M, et al. Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study. RMD Open. 2016;2(1):e000228. DOI:10.1136/rmdopen-2015-000228
12. Duquenne C, Wendling D, Sibilia J, et al. Glucocorticoid-sparing effect of first-year anti-TNFα treatment in rheumatoid arthritis (CORPUS Cohort). Clin Exp Rheumatol.
2017;35(4):638-46.
13. Fleischmann R, Wollenhaupt J, Cohen S, et al. Effect of Discontinuation or Initiation of Methotrexate or Glucocorticoids on Tofacitinib Efficacy in Patients with Rheumatoid Arthritis: A Post Hoc Analysis. Rheumatol Ther. 2018;5(1):203-14. DOI:10.1007/s40744-018-0093-7
14. Inoue M, Kanda H, Tateishi S, Fujio K. Factors associated with discontinuation of glucocorticoids after starting biological disease-modifying antirheumatic drugs in rheumatoid arthritis patients. Mod Rheumatol. 2020;30(1):58-63. DOI:10.1080/14397595.2018.1553264
15. Suzuki M, Kojima T, Takahashi N, et al. Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study. Mod Rheumatol. 2021;31(4):796-802. DOI:10.1080/14397595.2021.1879428
16. Spinelli FR, Garufi C, Mancuso S, et al. Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib. Sci Rep. 2023;13(1):15537. DOI:10.1038/s41598-023-42371-z
17. Wallace BI, England BR, Baker JF, et al. Lowering Expectations: Glucocorticoid Tapering Among Veterans With Rheumatoid Arthritis Achieving Low Disease Activity on Stable Biologic Therapy. ACR Open Rheumatol. 2023;5(9):437-42. DOI:10.1002/acr2.11584
18. Xie W, Huang H, Zhang Z. Dynamic Characteristics and Predictive Profile of Glucocorticoids Withdrawal in Rheumatoid Arthritis Patients Commencing Glucocorticoids with csDMARD: A Real-World Experience. Rheumatol Ther. 2023;10(2):405-19. DOI:10.1007/s40744-022-00527-9
19. Lauper K, Mongin D, Bergstra SA, et al. Evaluation and comparison of oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. 2023:105671. DOI:10.1016/j.jbspin.2023.105671
20. Гордеев А.В., Матьянова Е.В., Галушко Е.А. Длительный прием глюкокортикоидов больными активным ревматоидным артритом: терапевтический «стоп-кадр». Терапевтический архив. 2023;95(5):380-5 [Gordeev AV, Matyanova EV, Galushko EA. Long-term use of glucocorticoids in patients with active rheumatoid arthritis: therapeutic "freeze frame". Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(5):380-5 (in Russian)]. DOI:10.26442/00403660.2023.05.202196
21. Crowson LP, Davis JM 3rd, Hanson AC, et al. Time Trends in Glucocorticoid Use in Rheumatoid Arthritis During the Biologics Era: 1999-2018. Semin Arthritis Rheum. 2023;61:152219. DOI:10.1016/j.semarthrit.2023.152219
22. Adami G, Fassio A, Rossini M, et al. Tapering glucocorticoids and risk of flare in rheumatoid arthritis on biological disease-modifying antirheumatic drugs (bDMARDs). RMD Open. 2023;9(1):e002792. DOI:10.1136/rmdopen-2022-002792
23. Burmester GR, Buttgereit F, Bernasconi C, et al. Continuing versus tapering glucocorticoids after achievement of low disease activity or remission in rheumatoid arthritis (SEMIRA): a double-blind, multicentre, randomised controlled trial. Lancet. 2020;396(10246):267-76. DOI:10.1016/S0140-6736(20)30636-X
________________________________________________
2. Cutolo M, Shoenfeld Y, Bogdanos DP, et al. To treat or not to treat rheumatoid arthritis with glucocorticoids? A reheated debate. Autoimmun Rev. 2023:103437. DOI:10.1016/j.autrev.2023.103437
3. Hetland ML, Haavardsholm EA, Rudin A, et al. Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial. BMJ. 2020;371:m4328. DOI:10.1136/bmj.m4328
4. Boers M, Hartman L, Opris-Belinski D, et al. Low dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: the pragmatic randomised, double-blind placebo-controlled GLORIA trial. Ann Rheum Dis. 2022;81(7):925-36. DOI:10.1136/annrheumdis-2021-221957
5. Aronova EA, Belov BS, Gridneva GI. Revisiting the question of the safety of glucocorticoids use of in the treatment of rheumatoid arthritis. Modern Rheumatology Journal. 2023;17(3):89-95 (in Russian). DOI:10.14412/1996-7012-2023-3-89-95
6. Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023;82(1):3-18. DOI:10.1136/ard-2022-223356
7. Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2021;73(7):1108-23. DOI:10.1002/art.41752
8. Rheumatoid arthritis. Clinical recommendations. Available at: https://cr.minzdrav.gov.ru/schema/250_2. Accessed: 28.03.2024 (in Russian).
9. Pincus T, Cutolo M. Clinical trials documenting the efficacy of low-dose glucocorticoids in rheumatoid arthritis. Neuroimmunomodulation. 2015;22(1-2):46-50. DOI:10.1159/000362734
10. Nilsson AC, Christensen AF, Junker P, Lindegaard HM. Tumour necrosis factor-α inhibitors are glucocorticoid-sparing in rheumatoid arthritis. Dan Med Bull. 2011;58(4):A4257.
11. Alten R, Nüßlein H, Galeazzi M, et al. Decreased use of glucocorticoids in biological-experienced patients with rheumatoid arthritis who initiated intravenous abatacept: results from the 2-year ACTION study. RMD Open. 2016;2(1):e000228. DOI:10.1136/rmdopen-2015-000228
12. Duquenne C, Wendling D, Sibilia J, et al. Glucocorticoid-sparing effect of first-year anti-TNFα treatment in rheumatoid arthritis (CORPUS Cohort). Clin Exp Rheumatol.
2017;35(4):638-46.
13. Fleischmann R, Wollenhaupt J, Cohen S, et al. Effect of Discontinuation or Initiation of Methotrexate or Glucocorticoids on Tofacitinib Efficacy in Patients with Rheumatoid Arthritis: A Post Hoc Analysis. Rheumatol Ther. 2018;5(1):203-14. DOI:10.1007/s40744-018-0093-7
14. Inoue M, Kanda H, Tateishi S, Fujio K. Factors associated with discontinuation of glucocorticoids after starting biological disease-modifying antirheumatic drugs in rheumatoid arthritis patients. Mod Rheumatol. 2020;30(1):58-63. DOI:10.1080/14397595.2018.1553264
15. Suzuki M, Kojima T, Takahashi N, et al. Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study. Mod Rheumatol. 2021;31(4):796-802. DOI:10.1080/14397595.2021.1879428
16. Spinelli FR, Garufi C, Mancuso S, et al. Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib. Sci Rep. 2023;13(1):15537. DOI:10.1038/s41598-023-42371-z
17. Wallace BI, England BR, Baker JF, et al. Lowering Expectations: Glucocorticoid Tapering Among Veterans With Rheumatoid Arthritis Achieving Low Disease Activity on Stable Biologic Therapy. ACR Open Rheumatol. 2023;5(9):437-42. DOI:10.1002/acr2.11584
18. Xie W, Huang H, Zhang Z. Dynamic Characteristics and Predictive Profile of Glucocorticoids Withdrawal in Rheumatoid Arthritis Patients Commencing Glucocorticoids with csDMARD: A Real-World Experience. Rheumatol Ther. 2023;10(2):405-19. DOI:10.1007/s40744-022-00527-9
19. Lauper K, Mongin D, Bergstra SA, et al. Evaluation and comparison of oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. 2023:105671. DOI:10.1016/j.jbspin.2023.105671
20. Gordeev AV, Matyanova EV, Galushko EA. Long-term use of glucocorticoids in patients with active rheumatoid arthritis: therapeutic "freeze frame". Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(5):380-5 (in Russian). DOI:10.26442/00403660.2023.05.202196
21. Crowson LP, Davis JM 3rd, Hanson AC, et al. Time Trends in Glucocorticoid Use in Rheumatoid Arthritis During the Biologics Era: 1999-2018. Semin Arthritis Rheum. 2023;61:152219. DOI:10.1016/j.semarthrit.2023.152219
22. Adami G, Fassio A, Rossini M, et al. Tapering glucocorticoids and risk of flare in rheumatoid arthritis on biological disease-modifying antirheumatic drugs (bDMARDs). RMD Open. 2023;9(1):e002792. DOI:10.1136/rmdopen-2022-002792
23. Burmester GR, Buttgereit F, Bernasconi C, et al. Continuing versus tapering glucocorticoids after achievement of low disease activity or remission in rheumatoid arthritis (SEMIRA): a double-blind, multicentre, randomised controlled trial. Lancet. 2020;396(10246):267-76. DOI:10.1016/S0140-6736(20)30636-X
Авторы
А.С. Потапова*1, А.Е. Каратеев1, Е.Ю. Полищук1, Е.С. Филатова1, В.Н. Амирджанова1, А.М. Лила1,2
1ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
2ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*dr.aspotapova@mail.ru
1Nasonova Research Institute of Rheumatology, Moscow, Russia;
2Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*dr.aspotapova@mail.ru
1ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
2ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*dr.aspotapova@mail.ru
________________________________________________
1Nasonova Research Institute of Rheumatology, Moscow, Russia;
2Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*dr.aspotapova@mail.ru
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