THE REASONS OF RESISTANCE TO THE TNF α INHIBITORS AND WAYS OF ITS OVERCOMING

Abstract

The article presents a review of literature data, dedicated to problems of secondary ineffectiveness of infliximab in patients with rheumatoid arthritis. An analysis of available data showed that the main reason of resistance to the TNF α inhibitors is a synthesis of antibodies to the drug. Risk factors of antibodies production are absence of induction phase in treatment, prolongation of interval between infusions longer than 8 weeks, infliximab monotherapy. Treatment with chimerical antibodies to TNFα according an instruction: infusion on 0, 2 and 6 weeks and further not longer than in 8 weeks with necessary combinations with methotrexate in standard dose, — may decrease the risk of development of primary and secondary ineffectiveness of infliximab.Key words: children, infliximab, TNF a, juvenile rheumatoid arthritis, rheumatoid arthritis, secondary ineffectiveness.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(6):42-47)