Neutralisation of interferon gamma - a new trend in therapy of rheumatoid arthritis


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Abstract

Aim. To evaluate objectively therapeutic potentialities of a novel method of biological therapy - blocking interferon gamma (IF-γ) - by means of a comparative analysis of using antibodies to IF-g (anti-IF-γ) and tumor necrosis factor alpha (anti-TNF-α) in resistant rheumatoid arthritis (RA). Material and methods. A double blind trial included 55 patients with resistant RA. They received 5 intramuscular injections of anti-IF-y (n = 20), anti-TNF-a (n = 20) and placebo (15 patients). The results were assessed on the treatment day 7 and 28. Results. 16 patients withdrew because of the treatment uneffectiveness (2 from the group on anti-IF-g, 3 - on anti-TNF-α, 11 - on placebo). To the treatment day 28 the patients given anticytokines achieved significant improvement of all clinical indices while placebo group had no improvement. The highest response was observed in the group on anti-IF-γ (ACR 70). As shown by ultrasound investigation, a significant reduction of the synovial membrane thickness took place also in administration of anti-IF-γ Most frequent side effect of the anticytokine therapy was mild dermatitis at injection site on treatment day 8-11. Conclusion. Therapeutic efficacy of anti-IF-γ was comparable with efficacy of anti-TNF-α and even was superior in some aspects. The block of IF-γ holds much promise in the treatment of RA.

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Нейтрализация интерферона гамма - новое направление в терапии ревматоидного артрита. - Цель исследования. Объективно оценить терапевтический потенциал нового метода биологической терапии - блокирования интерферона гамма (ИФ-γ) посредством сравнительного анализа результатов применения антител к ИФ-γ (анти-ИФ-γ) и к α-фактору некроза опухоли (анти-α-ФНО) при резистентном ревматоидном артрите (РА). Материалы и методы. В двойное слепое исследование были включены 55 больных резистентным РА, которые получили 5 внутримышечных инъекций анти-ИФ-γ (20 пациентов), анти-α-ФНО (20 пациентов) и плацебо (15 пациентов). Результаты оценивали на 7-й и 28-й дни лечения. Результаты. 16 пациентов выбыли из исследования в связи с неэффективностью (2 - из протокола анти-ИФ-γ, 3 - анти-α-ФНО, 11 - плацебо). К 28-му дню после применения обоих антицитокинов было получено достоверное улучшение всех клинических показателей, в то время как в группе плацебо ни один показатель не улучшился. К этому сроку максимальный эффект (АКР 70) был достигнут только среди пациентов, получивших анти-ИФ-γ. Достоверное уменьшение толщины синовиальной мембраны по данным УЗИ было отмечено также только при применении анти-ИФ-γ. Самым частым побочным эффектом антицитокиновой терапии был легкий дерматит в местах инъекций на 8-11-й день. Заключение. Выраженность лечебного эффекта анти-ИФ-γ была сопоставима с эффектом анти-α-ФНО, но в некоторых аспектах превосходила его. Блокирование ИФ-γ может явиться новым перспективным направлением в терапии РА.
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