Use of biological therapy in patients with rheumatoid arthritis in the Republic of Kazakhstan

Aim. To evaluate the clinical efficacy and safety of infliximab (IFM) in patients with rheumatoid arthritis (RA). Subjects and methods. Twelve inpatients (10 women and 2 men) aged 23 to 65 years with a valid diagnosis of RA, the duration of which was 3 years or more, were retrospectively analyzed. DAS28 for RA corresponded to grades II and III in 4 (33.3%) and 8 (66.7%) patients, respectively. Long before the investigation, all the patients used methotrexate in a weekly dose of 15 mg and nonsteroidal anti-inflammatory drugs; 6 patients received methipred in a daily dose of 4-8 mg. IFM was administered intravenously dropwise on the basis of 3 mg/kg weight in 250 ml of isotonic sodium hydrochloride solution during 2 hours at 0, 2, and 6 weeks after therapy initiation and then every 8 weeks. Results. During combination therapy after the first IFM infusion, all the 12 patients were noted to have a positive clinical effect as a significant reduction in the number of tender joints and swollen joints, morning stiffness, erythrocyte sedimentation rate, C-reactive protein, regression of the clinical manifestations of the disease, and its laboratory activity. The therapy was tolerated well by all the patients. According to the EULAR criteria, a good therapeutic effect was observed in 10 (83%) patients and clinical remission was achieved in 2 (17%) patients. According to the ACR criteria, 50 and 70% improvement was seen in 1 (8%) and 9 (75%) patients, respectively. Two (17%) patients achieved remission. Conclusion. Combination therapy with IFM and MT for RA is highly effective, suppresses disease inflammatory activity and joint destruction; furthermore, there may be remission induction.