NEW APPROACHES TO BIOLOGICAL IMMUNOMODULATION THERAPY OF RHEUMATOID-ARTHRITIS - NEUTRALIZATION OF BASIC CYTOKINES

Aim. Investigation of efficacy of antibodies to interferons in rheumat oid arthritis (RA) versus relevant efficacy of the tumor necrosis fact or (TNF), comparison of the above cytokines in monotherapy and combine d treatment. Materials and methods. An open controlled randomized tria l of clinical benefit and tolerance of anticytokine antibodies was per formed in a group of RA patients at stage II III and IV (1, 20 and 4 p atients, respectively). The activity degree II and III was in 10 and 1 5 patients, respectively. All the patients had articular functional in sufficiency of the second degree. 21 patients failed previous therapy with basic drugs including immunodepressants. Results. The anticytokin e antibodies proved to be highly effective in RA. Positive changes in the disease activity were achieved early after the end of the 5-day co urse in 88% of patients. The most definite immediate therapeutic effec t was noted in usage of TNF antibodies both in monotherapy and in comb ination with other anticytokines. Long-term effect was the best in pat ients given antibodies to interferon gamma. Interferon-alpha antibodie s produced weaker effect. The combined treatment had no advantages ove r the monotherapy. Conclusion. A significant therapeutic effect of ant ibodies to interferon-gamma is indicative of an important role of this cytokine in RA pathogenesis. Anticytokine antibodies are promising as a component of combined therapy of patients with resistant RA.