Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации10612Conference ProceedingsMorphological assessment of bone tissue changes under the influence of cytostatic therapy: clinical and morphological observationGerolevAlexey Vladimirovich<p>student</p>vasyavasin1856@yandex.ruhttps://orcid.org/0009-0005-9513-497XIonovaAnastasia Alekseevna<p>student</p>alsciaukat@yandex.ruhttps://orcid.org/0009-0006-1363-4661VetlitsynaSvetlana Vladimirovna<p>student</p>vasyavasin1855@yandex.ruhttps://orcid.org/0009-0003-9951-801XChikaevaAminate Akhmedovna<p>student</p>vasyavasin1855@yandex.ruhttps://orcid.org/0009-0008-4375-5020StupnovichDiane Vyacheslavovna<p>student</p>vasyavasin1855@yandex.ruhttps://orcid.org/0009-0002-5746-0713Pirogov Russian National Research Medical UniversityPetrovsky Medical University "Petrovsky National Research Center of Surgery"3006202514153550103202530032025Copyright © 2025, Gerolev A.V., Ionova A.A., Vetlitsyna S.V., Chikaeva A.A., Stupnovich D.V.2025<p><em>In clinical practice, both in the treatment of malignant neoplasms and in inflammatory diseases of various etiologies, cytostatic drugs are used. Given the statistics that confirm the increase in cases of rheumatic diseases, the use of cytostatic therapy and the study of its side effects are becoming increasingly relevant. Methotrexate is an immunosuppressive agent with antifolate properties, which has been used since the end of the last century and is the "gold standard" in the treatment of rheumatoid arthritis. However, methotrexate has a fairly large list of undesirable drug reactions, among which "methotrexate osteopathy" is noted, presumably associated with a violation of the vital processes of osteocytes, which is accompanied by a decrease in bone density with an increased risk of bone fractures of the lower extremities. The recommended combination of the drug with folic acid, aimed at preventing the antifolate effect of methotrexate does not guarantee the absence of methotrexate osteopathy during treatment with this cytostatic agent. Lack of awareness about this side effect of methotrexate therapy leads to misinterpretation of clinical symptoms and continuation of therapy, exacerbating side effects from the musculoskeletal system. It should be mentioned that the exact mechanism of development of osteoporosis caused by methotrexate is still unknown, which necessitates a comprehensive study of this phenomenon, including a morphological assessment of bone changes. Based on the above, the purpose of this work is to determine the features of the morphological picture of bone tissue after exposure to a cytostatic drug.</em></p>cytostatic therapyrheumatoid arthritismethotrexatemethotrexate osteopathybone tissuepathological anatomyцитостатическая терапияревматоидный артритметотрексатметотрексатная остеопатиякостная тканьпатологическая анатомия1.Русинович, В. Д. Коморбидная патология при ревматоидном артрите / В. Д. Русинович, М. В. Савонова, М. А. Семенович // Наука через призму времени. – 2022. – № 5(62). – С. 67-69. – EDN CTNIZN.2.Насырова, М. Ш. Современное состояние и актуальные вопросы ревматоидного артрита / М. Ш. Насырова // Вестник Академии медицинских наук Таджикистана. – 2019. – Т. 9, № 4(32). – С. 424-429. – DOI 10.31712/2221-7355-2019-9-4-424-429. – EDN XEJZNS.3.Метотрексат в лечении аутоиммунных ревматических заболеваний / В. В. Киреев, Ш. Х. Зиядуллаев, Т. У. Арипова, А. А. Суяров // Журнал теоретической и клинической медицины. – 2021. – № 2. – С. 48-53. – EDN FHVWCJ.4.Singh D, Hesse N, Skapenko A, Schulze-Koops H. A rare side effect of methotrexate therapy: drug-induced osteopathy with multiple fractures of the lower limb. RMD Open. 2023;9(1):e002982. doi:10.1136/rmdopen-2023-0029825.Чичасова, Н. В. Метотрексат в лечении ревматоидного артрита и псориатического артрита / Н. В. Чичасова, А. М. Лила // Лечащий врач. – 2020. – № 7. – С. 42-51. – DOI 10.26295/OS.2020.12.42.002. – EDN HAXHGK.6.Robin F, Cadiou S, Albert JD, Bart G, Coiffier G, Guggenbuhl P. Methotrexate osteopathy: five cases and systematic literature review. Osteoporos Int. 2021;32(2):225-232. doi:10.1007/s00198-020-05664-x7.Ruffer N, Krusche M, Beil FT, Amling M, Kötter I, Rolvien T. Clinical features of methotrexate osteopathy in rheumatic musculoskeletal disease: A systematic review. Semin Arthritis Rheum. 2022;52:151952. doi:10.1016/j.semarthrit.2022.151952