{"id":20,"date":"2016-04-17T23:17:47","date_gmt":"2016-04-17T20:17:47","guid":{"rendered":"http:\/\/rheumatology.bg\/?p=20"},"modified":"2016-04-22T13:02:30","modified_gmt":"2016-04-22T10:02:30","slug":"tocilizumab-%d0%bf%d1%80%d0%b5%d0%b2%d1%8a%d0%b7%d1%85%d0%be%d0%b6%d0%b4%d0%b0-adalimumab-%d0%ba%d0%b0%d1%82%d0%be-%d0%bc%d0%be%d0%bd%d0%be%d1%82%d0%b5%d1%80%d0%b0%d0%bf%d0%b8%d1%8f","status":"publish","type":"post","link":"https:\/\/www.rheumatology.bg\/?p=20","title":{"rendered":"Tocilizumab \u043f\u0440\u0435\u0432\u044a\u0437\u0445\u043e\u0436\u0434\u0430 adalimumab \u043a\u0430\u0442\u043e \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f"},"content":{"rendered":"<p>\u041c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f\u0442\u0430 \u0441 \u0430\u043d\u0442\u0430\u0433\u043e\u043d\u0438\u0441\u0442\u0430 \u043d\u0430 \u0438\u043d\u0442\u0435\u0440\u043b\u0435\u0432\u043a\u0438\u043d-6 (IL-6) tocilizumab (<i>Ro-Actemra,<\/i> Roche) \u0435 \u043f\u043e-\u0435\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u0430 \u043e\u0442 \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f\u0442\u0430 \u0441 \u0431\u043b\u043e\u043a\u0435\u0440\u0430 \u043d\u0430 \u0442\u0443\u043c\u043e\u0440-\u043d\u0435\u043a\u0440\u043e\u0442\u0438\u0437\u0438\u0440\u0430\u0449 \u0444\u0430\u043a\u0442\u043e\u0440 \u0430\u043b\u0444\u0430 adalimumab(<i>Humira<\/i>, Abbott) \u043f\u0440\u0438 \u0440\u0435\u0432\u043c\u0430\u0442\u043e\u0438\u0434\u0435\u043d \u0430\u0440\u0442\u0440\u0438\u0442, \u0441\u043e\u0447\u0438 \u0444\u0430\u0437\u0430 4 \u043f\u0440\u043e\u0443\u0447\u0432\u0430\u043d\u0435\u0442\u043e ADACTA, \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u0435\u043d\u043e \u043d\u0430 EULAR 2012.\u00a0\u0414\u0438\u0437\u0430\u0439\u043d\u044a\u0442 \u043d\u0430 \u0441\u043f\u043e\u043d\u0441\u043e\u0440\u0438\u0440\u0430\u043d\u043e\u0442\u043e \u043e\u0442 \u0420\u043e\u0448 \u043f\u0440\u043e\u0443\u0447\u0432\u0430\u043d\u0435 \u0431\u0438\u043b \u0434\u0430 \u0441\u0435 \u0442\u0435\u0441\u0442\u0432\u0430 \u043f\u0440\u0435\u0432\u044a\u0437\u0445\u043e\u0434\u0441\u0442\u0432\u043e\u0442\u043e \u043d\u0430 tocilizumab (TCZ) \u0441\u043f\u0440\u044f\u043c\u043e adalimumab \u043f\u0440\u0438 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0438 \u0441 \u0420\u0410 \u0441 \u0434\u0430\u0432\u043d\u043e\u0441\u0442 \u043d\u0430\u0434 6 \u043c\u0435\u0441\u0435\u0446\u0430, \u043d\u0435\u0442\u043e\u043b\u0435\u0440\u0438\u0440\u0430\u0449\u0438 methotrexate.<\/p>\n<blockquote><p>\u041d\u0430\u0441\u0442\u043e\u044f\u0449\u0438\u0442\u0435 \u043f\u0440\u0435\u043f\u043e\u0440\u044a\u043a\u0438 \u043d\u0430 EULAR \u0441\u0430 \u0434\u0430 \u0441\u0435 \u0438\u0437\u043f\u043e\u043b\u0437\u0432\u0430 \u0430\u043d\u0442\u0438-TNF \u043a\u0430\u0442\u043e \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u043d \u0430\u0433\u0435\u043d\u0442 \u043d\u0430 \u043f\u0440\u044a\u0432 \u0438\u0437\u0431\u043e\u0440, \u043d\u043e \u0441\u043f\u043e\u0440\u0435\u0434 \u043d\u0430\u0441\u0442\u043e\u044f\u0449\u043e\u0442\u043e \u043f\u0440\u043e\u0443\u0447\u0432\u0430\u043d\u0435 \u043c\u043e\u0436\u0435 \u0441\u0435 \u043e\u043a\u0430\u0436\u0435, \u0447\u0435 \u0435 \u043f\u043e-\u0434\u043e\u0431\u0440\u0435 \u0434\u0430 \u0441\u0435 \u0438\u0437\u043f\u043e\u043b\u0437\u0432\u0430 \u0430\u043d\u0442\u0438-IL-6, \u043e\u0442\u043a\u043e\u043b\u043a\u043e\u0442\u043e \u0430\u043d\u0442\u0438-TNF, \u043e\u0431\u044f\u0441\u043d\u044f\u0432\u0430\u0442 \u0433\u043b\u0430\u0432\u043d\u0438\u0442\u0435 \u0430\u0432\u0442\u043e\u0440\u0438.<\/p><\/blockquote>\n<p>\u041f\u0440\u043e\u0443\u0447\u0432\u0430\u043d\u0435\u0442\u043e \u0432\u043a\u043b\u044e\u0447\u0432\u0430\u043b\u043e 325 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0438 \u0441 \u0420\u0410, \u043b\u0435\u043a\u0443\u0432\u0430\u043d\u0438 \u0441 \u043c\u0435\u0442\u043e\u0442\u0440\u0435\u043a\u0441\u0430\u0442, \u043d\u043e \u043d\u0435\u043b\u0435\u043a\u0443\u0432\u0430\u043d\u0438 \u0434\u043e\u0441\u0435\u0433\u0430 \u0441 \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u0430 \u0442\u0435\u0440\u0430\u043f\u0438\u044f. \u0442\u0435 \u0431\u0438\u043b\u0438 \u0440\u0430\u043d\u0434\u043e\u043c\u0438\u0437\u0438\u0440\u0430\u043d\u0438 \u043d\u0430 \u0438\u043d\u0442\u0440\u0430\u0432\u0435\u043d\u043e\u0437\u0435\u043d TCZ 8 mg\/kg \u043d\u0430 \u0432\u0441\u0435\u043a\u0438 4 \u0441\u0435\u0434\u043c\u0438\u0446\u0438 + \u043f\u043b\u0430\u0446\u0435\u0431\u043e, \u043f\u043e\u0434\u043a\u043e\u0436\u0435\u043d \u0430\u0434\u0430\u043b\u0438\u043c\u0443\u043c\u0430\u0431 (ADA) + \u043f\u043b\u0430\u0446\u0435\u0431\u043e \u0432\u0441\u0435\u043a\u0438 2 \u0441\u0435\u0434\u043c\u0438\u0446\u0438.<\/p>\n<p>\u041d\u0430 \u0441\u0435\u0434\u043c\u0438\u0446\u0430 24, \u0441\u0440\u0435\u0434\u043d\u0430\u0442\u0430 \u043f\u0440\u043e\u043c\u044f\u043d\u0430 \u0432 DAS 28 \u0441\u043f\u0440\u044f\u043c\u043e \u0431\u0430\u0437\u043e\u0432\u0438\u0442\u0435 \u043d\u0438\u0432\u0430 \u0431\u0438\u043b\u0430 \u043f\u043e-\u0438\u0437\u0440\u0430\u0437\u0435\u043d\u0430 \u043f\u0440\u0438 TVZ &#8211; \u0441\u0440\u0435\u0434\u043d\u0430 \u043f\u0440\u043e\u043c\u044f\u043d\u0430 \u0441 -3.3 \u0441\u043f\u0440\u044f\u043c\u043e 1.8. \u041f\u0440\u043e\u0446\u0435\u043d\u0442\u044a\u0442 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0438, \u043f\u043e\u0441\u0442\u0438\u0433\u043d\u0430\u043b\u0438 DAS 28 \u0440\u0435\u043c\u0438\u0441\u0438\u044f \u0431\u0438\u043b 39.9% \u0441\u0440\u0435\u0449\u0443 10.5%.<\/p>\n<p>TCZ \u0431\u0438\u043b \u043f\u043e-\u0435\u0444\u0435\u043a\u0442\u0438\u0432\u0435\u043d \u0438 \u043f\u0440\u0438 \u043f\u043e\u0441\u0442\u0438\u0433\u0430\u043d\u0435 \u043d\u0430 \u043d\u0438\u0441\u043a\u0430 \u0431\u043e\u043b\u0435\u0441\u0442\u043d\u0430 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442 \u0438 ACR20, 50 \u0438 70 \u043e\u0442\u0433\u043e\u0432\u043e\u0440\u0438 (65% \u0441\u0440\u0435\u0449\u0443 49.4%, 47.2% \u0441\u0440\u0435\u0449\u0443 27.8%, 32.5% \u0441\u0440\u0435\u0449\u0443 17.9%).<\/p>\n<p>\u041b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0430\u0442\u0430 \u0438\u043c\u0430\u043b\u0438 \u0441\u0445\u043e\u0434\u043d\u0430 \u0447\u0435\u0441\u0442\u043e\u0442\u0430 \u043d\u0430 \u043d\u0435\u0436\u0435\u043b\u0430\u043d\u0438 \u0440\u0435\u0430\u043a\u0446\u0438\u0438 (82.1% \u043f\u0440\u0438 TCZ \u0441\u0440\u0435\u0449\u0443 82.7% \u043f\u0440\u0438 ADA). \u0427\u0435\u0441\u0442\u043e\u0442\u0430\u0442\u0430 \u043d\u0430 \u0441\u0435\u0440\u0438\u043e\u0437\u043d\u0438 \u043d\u0435\u0436\u0435\u043b\u0430\u043d\u0438 \u0440\u0435\u0430\u043a\u0446\u0438\u0438 \u0431\u0438\u043b\u0430 11.7% \u0441\u0440\u0435\u0449\u0443 9.9% \u043f\u0440\u0438 ADA, \u0430 \u043d\u0430 \u0442\u0435\u0436\u043a\u0438 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 &#8211; 3.1% \u0432 \u0434\u0432\u0435\u0442\u0435 \u0433\u0440\u0443\u043f\u0438.<\/p>\n<p>\u041f\u0440\u0438 TCZ \u0433\u0440\u0443\u043f\u0430\u0442\u0430 \u0431\u0438\u043b\u0438 \u043e\u0442\u0447\u0435\u0442\u0435\u043d\u0438 \u043f\u043e-\u0433\u043e\u043b\u044f\u043c \u0431\u0440\u043e\u0439 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0438 \u0441 \u043f\u043e\u0432\u0438\u0448\u0435\u043d\u0438\u0435 \u043d\u0430 \u0430\u043c\u0438\u043d\u043e\u0442\u0440\u0430\u043d\u0441\u0444\u0435\u0440\u0430\u0437\u0438\u0442\u0435, LDL, \u043d\u0430\u043c\u0430\u043b\u0435\u043d\u0438\u0435 \u043d\u0430 \u043d\u0435\u0443\u0442\u0440\u043e\u0444\u0438\u043b\u0438\u0442\u0435.<\/p>\n<p>\u0412 \u043a\u043e\u043c\u0435\u043d\u0442\u0430\u0440 \u0434-\u0440 Xavier Mariette, \u043d\u0430\u0443\u0447\u0435\u043d \u043f\u0440\u0435\u0434\u0441\u0435\u0434\u0430\u0442\u0435\u043b \u043d\u0430 EULAR 2012 \u0441\u043c\u044f\u0442\u0430, \u0447\u0435 \u043d\u0435 \u0435 \u0447\u0435\u0441\u0442\u043d\u043e \u0434\u0430 \u0441\u0435 \u0438\u0437\u043f\u043e\u043b\u0437\u0432\u0430 adalimumab \u043a\u0430\u0442\u043e \u0441\u0440\u0430\u0432\u043d\u0438\u0442\u0435\u043b\u0435\u043d \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442. \u0412\u0441\u0435\u043a\u0438 \u0437\u043d\u0430\u0435, \u0447\u0435 \u0425\u0443\u043c\u0438\u0440\u0430 \u0434\u0435\u0439\u0441\u0442\u0432\u0430 \u043f\u043e-\u0434\u043e\u0431\u0440\u0435 \u0432 \u043a\u043e\u043c\u0431\u0438\u043d\u0430\u0446\u0438\u044f \u0441 \u043c\u0435\u0442\u043e\u0442\u0440\u0435\u043a\u0441\u0430\u0442, \u043e\u0442\u043a\u043e\u043b\u043a\u043e\u0442\u043e \u043a\u0430\u0442\u043e \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f. \u0411\u0438 \u0431\u0438\u043b\u043e \u043f\u043e-\u0443\u0434\u0430\u0447\u043d\u043e \u0434\u0430 \u0441\u0435 \u0441\u0440\u0430\u0432\u043d\u044f\u0442 \u043a\u043e\u043c\u0431\u0438\u043d\u0430\u0446\u0438\u0438\u0442\u0435 MTX+TCZ \u0438 MTX+ADA \u0438\u043b\u0438 \u043f\u044a\u043a \u0434\u0430 \u0441\u0435 \u0438\u0437\u043f\u043e\u043b\u0437\u0432\u0430 \u0434\u0440\u0443\u0433 \u0430\u043d\u0442\u0438-TNF,\u043a\u043e\u0439\u0442\u043e \u0434\u0435\u0439\u0441\u0442\u0432\u0430 \u043f\u043e-\u0434\u043e\u0431\u0440\u0435 \u043f\u0440\u0438 \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f \u043a\u0430\u0442\u043e etanercept.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u041c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f\u0442\u0430 \u0441 \u0430\u043d\u0442\u0430\u0433\u043e\u043d\u0438\u0441\u0442\u0430 \u043d\u0430 \u0438\u043d\u0442\u0435\u0440\u043b\u0435\u0432\u043a\u0438\u043d-6 (IL-6) tocilizumab (Ro-Actemra, Roche) \u0435 \u043f\u043e-\u0435\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u0430 \u043e\u0442 \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f\u0442\u0430 \u0441 \u0431\u043b\u043e\u043a\u0435\u0440\u0430 \u043d\u0430 \u0442\u0443\u043c\u043e\u0440-\u043d\u0435\u043a\u0440\u043e\u0442\u0438\u0437\u0438\u0440\u0430\u0449 \u0444\u0430\u043a\u0442\u043e\u0440 \u0430\u043b\u0444\u0430 adalimumab(Humira, <a class=\"mh-excerpt-more\" href=\"https:\/\/www.rheumatology.bg\/?p=20\" title=\"Tocilizumab \u043f\u0440\u0435\u0432\u044a\u0437\u0445\u043e\u0436\u0434\u0430 adalimumab \u043a\u0430\u0442\u043e \u043c\u043e\u043d\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":32,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-20","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-1"],"_links":{"self":[{"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/posts\/20","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20"}],"version-history":[{"count":10,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/posts\/20\/revisions"}],"predecessor-version":[{"id":53,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/posts\/20\/revisions\/53"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=\/wp\/v2\/media\/32"}],"wp:attachment":[{"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.rheumatology.bg\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}