Melokhina V. Clinical efficacy and adjustment of biologic anti-TNF agents in patients with rheumatoid arthritis and akylosing spondylitis

The object of the study is patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The aim is to improve results of treatment with biological anticytokine drugs (antibodies to tumor necrosis factor alfa (TNF)) of RA and AS patients due to development of method of treatment response prognosis. Clinical, biochemical, immunological, immunoenzyme, X-ray, statistical methods were used. Novelty and results - for the first time the correlation between TNF production by blood mononuclear cells and RA and AS course, correlation between intensity of proinflammatory cytokines expression by blood cells and anti-TNF biologicals treatment effectiveness were studied. Peculiarities of proinflammatory and antiinflammatory cytokines production in responders and non-responders were also investigated. Dynamics of in vivo and in vitro TNF production during therapy with monoclonal anti-TNF antibodies was studied. New method of biological therapy effectiveness prognosis was developed on the basis of predictor laboratory tests. Proposals on RA and AS treatment strategy optimization were done. They were implemented into practice of SI "Institute of Urgent and Recovery Surgery named after V.K.Gusak of AMS of Ukraine", Donetsk Regional Medical Union, Therapy Clinic of Donetsk National medical university named after M.Gorkiy and also educational work of Donetsk National medical university named after M.Gorkiy. The field of its use is treatment and diagnostic process of therapy and rheumatology departments, educational process of therapy Chairs of medical educational institutions.