mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-2014-1-71-80mimmun-27Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ ПРИМЕНЕНИЯ АГОНИСТОВ РЕЦЕПТОРОВ, АКТИВИРУЕМЫХ ПЕРОКСИСОМНЫМ ПРОЛИФЕРАТОРОМ АЛЬФА, У БОЛЬНЫХ РЕВМАТОИДНЫМ АРТРИТОМ: ОТКРЫТОЕ КОНТРОЛИРУЕМОЕ ИССЛЕДОВАНИЕCLINICAL EFFICACY AND SAFETY OF PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR ALPHA AGONISTS IN RHEUMATOID ARTHRITIS: AN OPEN-LABEL CONTROLLED STUDYШиринскийВ. С.ShirinskyV. S.

д.м.н., профессор, заведующий лабораторией клинической иммунофармакологии

PhD, MD (Medicine), Professor, Chief, Laboratory of Clinical Immunopharmacology

ishirinsky@mail.ruПоловниковаО. А.PolovnikovaO. A.

младший научный сотрудник лаборатории клинической иммунофармакологии

Research Associate, Laboratory of Clinical Immunopharmacology

ishirinsky@mail.ruКалиновскаяН. Ю.KalinovskayaN. Yu.

научный сотрудник лаборатории клинической иммунофармакологи

PhD (Medicine), Senior Researcher, Laboratory of Clinical Immunopharmacology

ishirinsky@mail.ruШиринскийИ. В.ShirinskyI. V.

д.м.н., ведущий научный сотрудник лаборатории клинической иммунофармакологии

PhD, MD (Medicine), Senior Researcher Fellow, Laboratory of Clinical Immunopharmacology

ishirinsky@mail.ruФГБУ «НИИ клинической иммунологии» СО РАМН, г. НовосибирскРоссияResearch Institute of Clinical Immunology, Russian Academy of Medical Sciences, Siberian Branch, NovosibirskRussian Federation2014070720141617180Copyright © Ширинский В.С., Половникова О.А., Калиновская Н.Ю., Ширинский И.В., 20142014Ширинский В.С., Половникова О.А., Калиновская Н.Ю., Ширинский И.В.Shirinsky V.S., Polovnikova O.A., Kalinovskaya N.Y., Shirinsky I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/27

В контролируемом исследовании изучалась эффективность применения агониста PPARα (фенофибрата), его фармакодинамика у больных ревматоидным артритом, получавших стандартные DMARD. После 12 недель лечения в опытной группе (33 больных) в сравнении с контрольной группой (17 больных) зарегистрировано статистически значимое снижение интегрального показателя активности DAS28 и его составляющих: числа болезненных и припухших суставов, СОЭ. Частота EULAR и ACR20 ответов в опытной группе в 4 раза превышала частоту в контрольной группе больных. Клинический эффект был сопряжен со снижением иммунологических маркеров атеросклероза (IL-6 и СРБ), уменьшением общего уровня холестерина и триглицеридов в сыворотке крови. Заключается, что агонисты PPARα являются примером «узловой» терапии ревматоидного артрита с плейотропным действием и направленной на снижение активности воспаления и риска развития коморбидной патологии – атеросклероза

Efficacy and pharmacodynamics of PPARα agonist fenofibrate have been assessed in a controlled study on patients with active rheumatoid arthritis (RA) receiving traditional DMARDs. After 12 weeks of treatment, we observed a significant drop of DAS28 scores, decrease in number of tender and swollen joints, and slower ESR in fenofibrate group (n = 33) as compared with control group (n = 17). Frequency of EULAR and ACR20 responses was 4 times higher in fenofibrate group. Clinical effect was accompanied by decrease in serum immunological markers of atherosclerosis (IL-6 and CRP), diminished total cholesterol andtriglycerides. In summary, PPARα agonists may represent an example of a “hub” treatment for rheumatoid arthritis, with pleiotropic effects directed at inflammatory activity and increased risk of other comorbidites, including atherosclerosis.

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