rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2014-147-158rsp-1918Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHРоссийский опыт применения моноклональных антител к В-лимфоцитам (ритуксимаб) при системных васкулитах, ассоциированных с антинейтрофильными цитоплазматическими антителами (предварительные результаты российского регистра НОРМА)RUSSIAN EXPERIENCE WITH USING MONOCLONAL ANTIBODIES TO B-LYMPHOCYTES (RITUXIMAB) IN SYSTEMIC VASCULITIDES ASSOCIATED WITH NEUTROPHIL CYTOPLASMIC ANTIBODIES (PRELIMINARY RESULTS OF THE RUSSIAN REGISTER NORMA)БекетоваТ. В.BeketovaT. V.tvbek@rambler.ruАлександроваЕ. Н.AleksandrovaE. N.НовоселоваТ. М.NovoselovaT. M.СажинаЕ. Г.SazhinaE. G.НиколаеваЕ. В.NikolaevaE. V.СмирновА. В.SmirnovA. V.СороцкаяВ. Н.SorotskayaV. N.ЗемероваЕ. В.ZemerovaE. V.НамИ. Ф.NamI. F.НикитинаН. М.NikitinaN. M.АрхангельскаяГ. С.ArkhangelskayaG. S.БагаутдиноваЗ. Р.BagautdinovaZ. R.ДашковИ. Н.DashkovI. N.ЧерныхС. Ю.ChernykhS. Yu.ЖирноваО. В.ZhirnovaO. V.ЛушпаеваЮ. А.LushpaevaYu. A.МасневаЛ. В.MasnevaL. V.АфанасьеваИ. П.AfanasievaI. P.АрсеньевА. Е.ArsenievA. E.КондратенкоИ. В.KondratenkoI. V.БашковаИ. Б.BashkovaI. B.ГлуховаС. И.GlukhovaS. I.НасоновЕ. Л.NasonovE. L.ФГБУ «Научно-исследовательский институт ревматологии им. В.А.Насоновой» РАМН, Москва, РоссияРоссияV.A. Nasonova Research Institute of Rheumatology of the Russian Academy of Medical Sciences, Moscow, RussiaRussian FederationМедицинский институт ФГБОУ ВПО «Тульский государственный университет», Тула, РоссияРоссияMedical Institute, Tula State University, Tula, RussiaRussian FederationБУ ХМАО-Югры «Окружная клиническая больница», Ханты-Мансийск, РоссияРоссияCounty Clinical Hospital, Khanty-Mansiysk, RussiaRussian FederationГБОУ ВПО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России, СаратовРоссияV.I. Razumovsky State Medical University, Ministry of Health of Russia, SaratovRussian FederationГБУ Самарской области «Самарская городская больница № 4», СамараРоссияSamara City Hospital Four, SamaraRussian FederationБУЗ Удмуртской Республики «Республиканский клинико-диагностический центр Министерства здравоохранения Удмуртской Республики», ИжевскРоссияRepublican Clinical and Diagnostic Center, Ministry of Health of the Udmurt Republic, IzhevskRussian FederationГАУЗ «Брянская областная больница № 1», БрянскРоссияBryansk Regional Hospital One, BryanskRussian FederationОГАУЗ «Иркутская городская клиническая больница № 1», ИркутскРоссияIrkutsk City Clinical Hospital One, IrkutskRussian FederationГБУЗ Тверской области «Областная клиническая больница», ТверьРоссияTver Regional Clinical Hospital, TverRussian FederationТюменский областной ревматологический центр ГБУЗ ТО «Областная клиническая больница №1», ТюменьРоссияTyumen Regional Rheumatology Center, Regional Clinical Hospital One, TumenRussian FederationОГБУЗ «Белгородская областная клиническая больница Святителя Иоасафа», БелгородРоссияSaint Ioasaf Belgorod Regional Clinical Hospital, BelgorodRussian FederationОБУЗ «Ивановская областная клиническая больница», ИвановоРоссияIvanovo Regional Clinical Hospital, IvanovoRussian FederationФГБУ «Российская детская клиническая больница» Минздрава России, МоскваРоссияRussian Children’s Clinical Hospital, Ministry of Health of Russia, MoscowRussian FederationФГБОУ ВПО «Чувашский государственный университет им. И.Н. Ульянова» , ЧебоксарыРоссияI.N. Ulyanov Chuvash State University, CheboksaryRussian Federation201417062014522НАУЧНО-ПРАКТИЧЕСКАЯ РЕВМАТОЛОГИЯ 52 No 2-2014147158Copyright © Бекетова Т.В., Александрова Е.Н., Новоселова Т.М., Сажина Е.Г., Николаева Е.В., Смирнов А.В., Сороцкая В.Н., Земерова Е.В., Нам И.Ф., Никитина Н.М., Архангельская Г.С., Багаутдинова З.Р., Дашков И.Н., Черных С.Ю., Жирнова О.В., Лушпаева Ю.А., Маснева Л.В., Афанасьева И.П., Арсеньев А.Е., Кондратенко И.В., Башкова И.Б., Глухова С.И., Насонов Е.Л., 20142014Бекетова Т.В., Александрова Е.Н., Новоселова Т.М., Сажина Е.Г., Николаева Е.В., Смирнов А.В., Сороцкая В.Н., Земерова Е.В., Нам И.Ф., Никитина Н.М., Архангельская Г.С., Багаутдинова З.Р., Дашков И.Н., Черных С.Ю., Жирнова О.В., Лушпаева Ю.А., Маснева Л.В., Афанасьева И.П., Арсеньев А.Е., Кондратенко И.В., Башкова И.Б., Глухова С.И., Насонов Е.Л.Beketova T.V., Aleksandrova E.N., Novoselova T.M., Sazhina E.G., Nikolaeva E.V., Smirnov A.V., Sorotskaya V.N., Zemerova E.V., Nam I.F., Nikitina N.M., Arkhangelskaya G.S., Bagautdinova Z.R., Dashkov I.N., Chernykh S.Y., Zhirnova O.V., Lushpaeva Y.A., Masneva L.V., Afanasieva I.P., Arseniev A.E., Kondratenko I.V., Bashkova I.B., Glukhova S.I., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1918

В 2013 г. в России официально зарегистрированы показания для применения моноклональных антител к В-лимфо- цитам (ритуксимаб, РТМ) при системных васкулитах, ассоциированных с антинейтрофильными цитоплазматиче- скими антителами (АНЦА-СВ). Данное сообщение представляет предварительные результаты Российского регист- ра применения РТМ при аутоиммунных заболеваниях (НОРМА), включившего 50 больных АНЦА-СВ, получавших лечение в 14 городах Российской Федерации. У 25 из 50 (50%) пациентов проводили повторные курсы РТМ. В условиях реальной отечественной клинической практики РТМ проявил высокую эффективность у больных АНЦА-СВ с хорошим профилем безопасности лечения. Среди 25 пациентов, наблюдавшихся более 12 мес, ремис- сия была достигнута в 92% случаев, в 8% наблюдалось снижение активности АНЦА-СВ. Эффективность РТМ воз- растала при использовании повторных курсов, при этом отмечено, что положительные результаты могут быть полу- чены при назначении повторных курсов РТМ в редуцированных дозах (500–1000 мг). Назначение повторных кур- сов в первую очередь потребовалось больным гранулематозом с полиангиитом с поражением легких. Требуется осторожность при сочетании лечения РТМ с цитостатиками (прежде всего с циклофосфаном) в связи с опасностью вторичного иммунодефицитного состояния и инфекционных нежелательных реакций (НР), которые были наиболее частыми серьезными НР (12%) у больных АНЦА-СВ.

In 2013, Russia registered officially the indications for the use of monoclonal antibodies to B-lymphocytes (rituximab, RTM) in systemic vasculitides associated with antineutrophil cytoplasmic antibodies (ANCA-SV). This communication presents the preliminary results of the Russian register of the RTM application in autoimmune diseases (NORMA) that has included 50 patients with ANCA-SV treated in 14 cities of the Russian Federation. Twenty-five of 50 (50%) patients received repeated courses of RTM. RTM has demonstrated a high efficacy and a good profile of treatment safety in patients with ANCA-SV in real-life national clinical practice. Among 25 patients who had been followed up for over 12 months, the remission was achieved in 92% of cases, a decrease in the ANCA-SV activity was observed in 8%. The efficacy of RTM increased when performing repeated courses, while it has been noted that the positive results can be obtained by prescribing a repeated course of RTM at a reduced dose (500–1000 mg). Prescription of the repeated courses was primarily required in patients with granulomatosis and polyangiitis affecting the lungs. Care should be taken when combining RTM treatment with cytostatics (primarily with cyclophosphamide) because of the risk of secondary immunodeficiency and infectious adverse events (AE), which have been the most frequent serious AE (12%) in patients with ANCA-SV.

системный васкулитассоциированный с антинейтрофильными цитоплазматическими антитела- мигранулематоз с полиангиитом Вегенерамикроскопический полиангиитэозинофильный гранулематоз с поли- ангиитом Черджа–Стросбиологическая анти-В-клеточная терапияsystemic vasculitis associated with neutrophil cytoplasmic antibodiesWegener's granulomatosis with polyangiitismicroscopic polyangiitiseosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrom)biological anti-B cell therapyrituximabReferencesJones R, Cohen Tervaert J, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med. 2010;363(3):211–20. DOI: 10.1056/NEJMoa0909169.Jones R, Cohen Tervaert J, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med. 2010;363(3):211–20. DOI: 10.1056/NEJMoa0909169.Stone J, Merkel P, Spiera R, et al.; RAVE-ITN Research Group. Rituximab versus cyclophosphamide for ANCA-associated vas- culitis. N Engl J Med. 2010;363(3):221–32. DOI: 10.1056/NEJMoa0909905.Stone J, Merkel P, Spiera R, et al.; RAVE-ITN Research Group. Rituximab versus cyclophosphamide for ANCA-associated vas- culitis. N Engl J Med. 2010;363(3):221–32. DOI: 10.1056/NEJMoa0909905.Luqmani R, Bacon P, Moots R, et al. Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis. QJM. 1994;87(11):671–8.Luqmani R, Bacon P, Moots R, et al. Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis. QJM. 1994;87(11):671–8.Hellmich B, Flossman O, Gross WL, et al. EULAR recommenda- tions for conducting clinical studies and/or clinical trials in sys- temic vasculitis: focus on anti-neutrophil cytoplasm antibody- associated vasculitis. Ann Rheum Dis. 2007;66(5):605–17. DOI: http://dx.doi.org/10.1136/ard.2006.062711Epub 2006 Dec 14.Hellmich B, Flossman O, Gross WL, et al. EULAR recommenda- tions for conducting clinical studies and/or clinical trials in sys- temic vasculitis: focus on anti-neutrophil cytoplasm antibody- associated vasculitis. Ann Rheum Dis. 2007;66(5):605–17. DOI: http://dx.doi.org/10.1136/ard.2006.062711Epub 2006 Dec 14.Leavitt RY, Fauci A, Block D, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum. 1990;33(8):1101–7. DOI: http://dx.doi.org/10.1002/art.1780330807.Leavitt RY, Fauci A, Block D, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum. 1990;33(8):1101–7. DOI: http://dx.doi.org/10.1002/art.1780330807.Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1–11. DOI: 10.1002/art.37715.Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1–11. DOI: 10.1002/art.37715.Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990;33(8):1094–100. DOI: http://dx.doi.org/10.1002/art.1780330806.Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990;33(8):1094–100. DOI: http://dx.doi.org/10.1002/art.1780330806.Guillevin L, Pagnoux C, Seror R, et al. The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculi- tides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore). 2011 Jan;90(1):19–27. DOI: 10.1097/MD.0b013e318205a4c6.Guillevin L, Pagnoux C, Seror R, et al. The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculi- tides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore). 2011 Jan;90(1):19–27. DOI: 10.1097/MD.0b013e318205a4c6.Lyons PA, Rayner TF, Trivedi S, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012;367(3):214–23. DOI: http://dx.doi.org/10.1056/NEJMoa1108735.Lyons PA, Rayner TF, Trivedi S, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012;367(3):214–23. DOI: http://dx.doi.org/10.1056/NEJMoa1108735.Bosch X, Guilabert А, Espinosa G, Mirapeix E. Treatment of anti- neutrophil cytoplasmic antibody associated vasculitis: a systematic review. JAMA. 2007;298(6):655–69. DOI: http://dx.doi.org/10.1001/jama.298.6.655.Bosch X, Guilabert А, Espinosa G, Mirapeix E. Treatment of anti- neutrophil cytoplasmic antibody associated vasculitis: a systematic review. JAMA. 2007;298(6):655–69. DOI: http://dx.doi.org/10.1001/jama.298.6.655.Насонов ЕЛ, редактор. Анти-В-клеточная терапияНасонов ЕЛ, редактор. Анти-В-клеточная терапияв ревматологии: фокус на ритуксимаб. Москва: ИМА-Пресс; 2012. 343 с. [Nasonov EL, editor. Anti-В-kletochnaya terapiya v revmatologii: fokus na rituksimab [Anti-B-cellular therapy in rheumatology: focus on rituksimab]. Moscow: IMA-Press; 2012. 343 p.]в ревматологии: фокус на ритуксимаб. Москва: ИМА-Пресс; 2012. 343 с. [Nasonov EL, editor. Anti-В-kletochnaya terapiya v revmatologii: fokus na rituksimab [Anti-B-cellular therapy in rheumatology: focus on rituksimab]. Moscow: IMA-Press; 2012. 343 p.]Specks U, Stone JH; the RAVE-ITN Research Group. Long-term efficacy and safety results of the RAVE trial. Clin Exp Immunol. 2011;164:65.Specks U, Stone JH; the RAVE-ITN Research Group. Long-term efficacy and safety results of the RAVE trial. Clin Exp Immunol. 2011;164:65.Jones RB, Walsh M, Jayne DRW, et al. Two-year follow-up results from a randomized trial of RTX versus CyP for ANCA-associated renal vasculitis: RITUXVAS. Clin Exp Immunol. 2011;164:57.Jones RB, Walsh M, Jayne DRW, et al. Two-year follow-up results from a randomized trial of RTX versus CyP for ANCA-associated renal vasculitis: RITUXVAS. Clin Exp Immunol. 2011;164:57.Roll P, Ostermeier E, Haubitz M, et al. Efficacy and safety of rit- uximab treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitides: results from a German registry (GRAID). J Rheumatol. 2012;39(11):2153–6. DOI: 10.3899/jrheum.120482. Epub 2012 Sep 15.Roll P, Ostermeier E, Haubitz M, et al. Efficacy and safety of rit- uximab treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitides: results from a German registry (GRAID). J Rheumatol. 2012;39(11):2153–6. DOI: 10.3899/jrheum.120482. Epub 2012 Sep 15.Charles P, Neel A, Tieulie N, et al. Rituximab for induction and maintenance treatment of ANCA-associated vasculitides: a multi- centre retrospective study on 80 patients. Rheumatology (Oxford). 2014 Mar;53(3):532-9. DOI: 10.1093/rheumatology/ket381. Epub 2013 Nov 26.Charles P, Neel A, Tieulie N, et al. Rituximab for induction and maintenance treatment of ANCA-associated vasculitides: a multi- centre retrospective study on 80 patients. Rheumatology (Oxford). 2014 Mar;53(3):532-9. DOI: 10.1093/rheumatology/ket381. Epub 2013 Nov 26.Jones RB, Ferraro AJ, Chaudhry AN, et al. A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 2009;60(7):2156–68. DOI: http://dx.doi.org/10.1002/art.24637.Jones RB, Ferraro AJ, Chaudhry AN, et al. A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 2009;60(7):2156–68. DOI: http://dx.doi.org/10.1002/art.24637.Holle JU, Dubrau C, Herlyn K, et al. Rituximab for refractory granulomatosis with polyangiitis (Wegener's granulomatosis): com- parison of efficacy in granulomatous versus vasculitic manifesta- tions. Ann Rheum Dis. 2012;71(3):327–33. DOI: http://dx.doi.org/10.1136/ard.2011.153601.Holle JU, Dubrau C, Herlyn K, et al. Rituximab for refractory granulomatosis with polyangiitis (Wegener's granulomatosis): com- parison of efficacy in granulomatous versus vasculitic manifesta- tions. Ann Rheum Dis. 2012;71(3):327–33. DOI: http://dx.doi.org/10.1136/ard.2011.153601.Visentini M, Ludovisi S, Petrarca A, et al. A phase II, single-arm multicenter study of low-dose rituximab for refractory mixed cryo- globulinemia secondary to hepatitis C virus infection. Autoimmun Rev. 2011;10(11):714–9. DOI: http://dx.doi.org/10.1016/j.autrev.2011.04.033.Visentini M, Ludovisi S, Petrarca A, et al. A phase II, single-arm multicenter study of low-dose rituximab for refractory mixed cryo- globulinemia secondary to hepatitis C virus infection. Autoimmun Rev. 2011;10(11):714–9. DOI: http://dx.doi.org/10.1016/j.autrev.2011.04.033.Emery P, Mease PJ, Rubbert-Roth A, et al. Retreatment with rit- uximab based on a treatment-to-target approach provides better disease control than treatment as needed in patients with rheuma- toid arthritis: a retrospective pooled analysis. Rheumatology (Oxford). 2011;50(12):2223–32. DOI: 10.1093/rheumatology/ker253. Epub 2011 Sep 16.Emery P, Mease PJ, Rubbert-Roth A, et al. Retreatment with rit- uximab based on a treatment-to-target approach provides better disease control than treatment as needed in patients with rheuma- toid arthritis: a retrospective pooled analysis. Rheumatology (Oxford). 2011;50(12):2223–32. DOI: 10.1093/rheumatology/ker253. Epub 2011 Sep 16.Smith RM, Jones RB, Guerry MJ, et al. Rituximab for remission maintenance in relapsing antineutrophilcytoplasmic antibody- associated vasculitis. Arthritis Rheum. 2012;64(11):3760–9. DOI: http://dx.doi.org/10.1002/art.34583.Smith RM, Jones RB, Guerry MJ, et al. Rituximab for remission maintenance in relapsing antineutrophilcytoplasmic antibody- associated vasculitis. Arthritis Rheum. 2012;64(11):3760–9. DOI: http://dx.doi.org/10.1002/art.34583.treated with rituximab in the autoimmunity and rituximab registry. Arthritis Rheum. 2010;62(9):2625–32. DOI: http://dx.doi.org/10.1002/art.27555.treated with rituximab in the autoimmunity and rituximab registry. Arthritis Rheum. 2010;62(9):2625–32. DOI: http://dx.doi.org/10.1002/art.27555.Wendt M, Gunnarson I, Bratt J, Bruchfeld A. Rituximab in relaps- ing or refractory ANCA-associated vasculitis: a case series of 16 patients. Scand J Rheumatol. 2012;41(2):116–9. DOI: 10.3109/03009742.2011.620573. Epub 2011 Nov 28.Wendt M, Gunnarson I, Bratt J, Bruchfeld A. Rituximab in relaps- ing or refractory ANCA-associated vasculitis: a case series of 16 patients. Scand J Rheumatol. 2012;41(2):116–9. DOI: 10.3109/03009742.2011.620573. Epub 2011 Nov 28.Pullerits R, Ljevakt M, Vikgren J, Bokarewa M. Off-trial evalua- tion of the B cell targeting treatment in the refractory cases of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculi- tis: long-term follow-up from a single centre. Scand J Immunol. 2012;76(4):411–20. DOI: 10.1111/j.1365-3083.2012.02747.x.Pullerits R, Ljevakt M, Vikgren J, Bokarewa M. Off-trial evalua- tion of the B cell targeting treatment in the refractory cases of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculi- tis: long-term follow-up from a single centre. Scand J Immunol. 2012;76(4):411–20. DOI: 10.1111/j.1365-3083.2012.02747.x.Tesfa D, Ajeganova S, Hä gglund H, et al. Late-onset neutropenia following rituximab therapy in rheumatic diseases: association with B lymphocyte depletion and infections. Arthritis Rheum. 2011;63(8):2209–14. DOI: 10.1002/art.30427.Tesfa D, Ajeganova S, Hä gglund H, et al. Late-onset neutropenia following rituximab therapy in rheumatic diseases: association with B lymphocyte depletion and infections. Arthritis Rheum. 2011;63(8):2209–14. DOI: 10.1002/art.30427.Besada E, Koldingsnes W, Nossent J. Characteristics of late onset neutropenia in rheumatologic patients treated with rituximab: a case review analysis from a single center. QJM. 2012;105(6):545–50. DOI: http://dx.doi.org/10.1093/qjmed/hcs015.Besada E, Koldingsnes W, Nossent J. Characteristics of late onset neutropenia in rheumatologic patients treated with rituximab: a case review analysis from a single center. QJM. 2012;105(6):545–50. DOI: http://dx.doi.org/10.1093/qjmed/hcs015.Мухин НА, Новиков ПИ, Моисеев СВ и др. Оценка краткосрочной эффективности и безопасности биологических препаратов при различных ревматических заболеваниях – опыт многопрофильного терапевтического стационара. Научно-практическая ревматология. 2013;51(2):138–44. [Mukhin NA, Novikov PI, Moiseev SV, et al. Evaluation of the short-term efficacy and safety of biological agents in different rheumatic diseases: a multidisciplinary thera- peutic hospital’s experience. Nauchno-prakticheskaya revma- tologiya = Rheumatology Science and Practice. 2013;51(2):138–44. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-Мухин НА, Новиков ПИ, Моисеев СВ и др. Оценка краткосрочной эффективности и безопасности биологических препаратов при различных ревматических заболеваниях – опыт многопрофильного терапевтического стационара. Научно-практическая ревматология. 2013;51(2):138–44. [Mukhin NA, Novikov PI, Moiseev SV, et al. Evaluation of the short-term efficacy and safety of biological agents in different rheumatic diseases: a multidisciplinary thera- peutic hospital’s experience. Nauchno-prakticheskaya revma- tologiya = Rheumatology Science and Practice. 2013;51(2):138–44. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-Rhee EP, Laliberte KA, Niles JL. Rituximab as maintenance ther- 640.Rhee EP, Laliberte KA, Niles JL. Rituximab as maintenance ther- 640.apy for anti-neutrophil cytoplasmic antibody-associated vasculitis. Clin J Am Soc Nephrol. 2010;5(8):1394–400. DOI: http://dx.doi.org/10.2215/CJN.08821209.apy for anti-neutrophil cytoplasmic antibody-associated vasculitis. Clin J Am Soc Nephrol. 2010;5(8):1394–400. DOI: http://dx.doi.org/10.2215/CJN.08821209.Besada E, Koldingsnes W, Nossent JC. Long-term efficacy and safety of pre-emptive maintenance therapy with rituximab in gran- ulomatosis with polyangiitis: results from a single centre. Rheumatology (Oxford). 2013;52(11):2041–7. DOI: http://dx.doi.org/10.1093/rheumatology/ket257.Besada E, Koldingsnes W, Nossent JC. Long-term efficacy and safety of pre-emptive maintenance therapy with rituximab in gran- ulomatosis with polyangiitis: results from a single centre. Rheumatology (Oxford). 2013;52(11):2041–7. DOI: http://dx.doi.org/10.1093/rheumatology/ket257.Kartin-Seba R, Goldbin J, Keoch KA, et al. Rituximab for emmission, induction and maintenance in ANCA-associated vas- culitis: a single centered 10-year experience in 108 patients. Arthritis Rheum. 2010;62 Suppl 10:680.Kartin-Seba R, Goldbin J, Keoch KA, et al. Rituximab for emmission, induction and maintenance in ANCA-associated vas- culitis: a single centered 10-year experience in 108 patients. Arthritis Rheum. 2010;62 Suppl 10:680.Roubaud-Baudron C, Pagnoux C, Meaux-Ruault N, et al. Rituximab maintenance therapy for granulomatosis with polyangiitis and microscopic polyangiitis. J Rheumatol. 2012;39(1):125–30. DOI: http://dx.doi.org/10.3899/jrheum.110143.Roubaud-Baudron C, Pagnoux C, Meaux-Ruault N, et al. Rituximab maintenance therapy for granulomatosis with polyangiitis and microscopic polyangiitis. J Rheumatol. 2012;39(1):125–30. DOI: http://dx.doi.org/10.3899/jrheum.110143.Available from: http://www.nice.org.uk/nicemedia/live/13960/65382/65382.pdfAvailable from: http://www.nice.org.uk/nicemedia/live/13960/65382/65382.pdfGregersen JW, Chaudhry A, Jayne DR. Rituximab for ANCA- associated vasculitis in the setting of severe infection. Scand J Rheumatol. 2013;42(3):207–10. DOI: http://dx.doi.org/10.3109/03009742.2012.739638.Gregersen JW, Chaudhry A, Jayne DR. Rituximab for ANCA- associated vasculitis in the setting of severe infection. Scand J Rheumatol. 2013;42(3):207–10. DOI: http://dx.doi.org/10.3109/03009742.2012.739638.Van Oers MH, van Glabbeke M, Giurgea L, et al. Rituximab maintenance treatment of relapsed/resistant follicular non- Hodgkin’s lymphoma: long-term outcome of the EORTC 20981 phase III randomized intergroup study. J Clin Oncol. 2010;28(17):2853–8. DOI: 10.1200/JCO.2009.26.5827. Epub 2010 May 3.Van Oers MH, van Glabbeke M, Giurgea L, et al. Rituximab maintenance treatment of relapsed/resistant follicular non- Hodgkin’s lymphoma: long-term outcome of the EORTC 20981 phase III randomized intergroup study. J Clin Oncol. 2010;28(17):2853–8. DOI: 10.1200/JCO.2009.26.5827. Epub 2010 May 3.Van Vollenhoven RF, Emery P, Bingham CO, et al. Long-term safety of patients receiving rituximab in rheumatoid arthritis clini- cal trials. J Rheumatol. 2010;37(3):558–67. DOI: 10.3899/jrheum.090856. Epub 2010 Jan 28.Van Vollenhoven RF, Emery P, Bingham CO, et al. Long-term safety of patients receiving rituximab in rheumatoid arthritis clini- cal trials. J Rheumatol. 2010;37(3):558–67. DOI: 10.3899/jrheum.090856. Epub 2010 Jan 28.Gottenberg JE, Ravaud P, Bardin T, et al.; AutoImmunity and Rituximab registry and French Society of Rheumatology. Risk fac- tors for severe infections in patients with rheumatoid arthritisGottenberg JE, Ravaud P, Bardin T, et al.; AutoImmunity and Rituximab registry and French Society of Rheumatology. Risk fac- tors for severe infections in patients with rheumatoid arthritisKaushik VV, Reddy HV, Bucknall RC. Successful use of rituximab in a patient with recalcitrant Churg-Strauss syndrome. Ann Rheum Dis. 2006;65(8):1116–7. DOI: http://dx.doi.org/10.1136/ard.2005.047308.Kaushik VV, Reddy HV, Bucknall RC. Successful use of rituximab in a patient with recalcitrant Churg-Strauss syndrome. Ann Rheum Dis. 2006;65(8):1116–7. DOI: http://dx.doi.org/10.1136/ard.2005.047308.Donvik KK, Omdal R. Churg-Strauss syndrome successfully treat- ed with rituximab. Rheumatol Int. 2010;31(1):89–91. DOI: 10.1007/s00296-009-1146-6. Epub 2009 Sep 30.Donvik KK, Omdal R. Churg-Strauss syndrome successfully treat- ed with rituximab. Rheumatol Int. 2010;31(1):89–91. DOI: 10.1007/s00296-009-1146-6. Epub 2009 Sep 30.Saech J, Owczarczyk K, Owczarzyk K, et al. Successful use of rit- uximab in a patient with Churg-Strauss syndrome and refractory central nervous system involvement. Ann Rheum Dis. 2010;69(6):1254–5. DOI: 10.1136/ard.2009.109850. Epub 2009 Sep 9.Saech J, Owczarczyk K, Owczarzyk K, et al. Successful use of rit- uximab in a patient with Churg-Strauss syndrome and refractory central nervous system involvement. Ann Rheum Dis. 2010;69(6):1254–5. DOI: 10.1136/ard.2009.109850. Epub 2009 Sep 9.Cartin-Ceba R, Keogh KA, Specks U, et al. Rituximab for the treatment of Churg-Strauss syndrome with renal involvement. Nephrol Dial Transplant. 2011;26(9):2865–71. DOI: 10.1093/ndt/gfq852. Epub 2011 Feb 16.Cartin-Ceba R, Keogh KA, Specks U, et al. Rituximab for the treatment of Churg-Strauss syndrome with renal involvement. Nephrol Dial Transplant. 2011;26(9):2865–71. DOI: 10.1093/ndt/gfq852. Epub 2011 Feb 16.Pepper RJ, Fabre MA, Pavesio C, et al. Rituximab is effective in the treatment of refractory Churg-Strauss syndrome and is associ- ated with diminished T-cell interleukin-5 production. Rheumatology (Oxford). 2008;47(7):1104–5. DOI: 10.1093/rheumatology/ken175. Epub 2008 May 20.Pepper RJ, Fabre MA, Pavesio C, et al. Rituximab is effective in the treatment of refractory Churg-Strauss syndrome and is associ- ated with diminished T-cell interleukin-5 production. Rheumatology (Oxford). 2008;47(7):1104–5. DOI: 10.1093/rheumatology/ken175. Epub 2008 May 20.Thiel J, Hä ssler F, Salzer U, et al. Rituximab in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangi- itis (Churg-Strauss syndrome). Arthritis Res Ther. 2013;15(5):R133. DOI: 10.1186/ar4313.Thiel J, Hä ssler F, Salzer U, et al. Rituximab in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangi- itis (Churg-Strauss syndrome). Arthritis Res Ther. 2013;15(5):R133. DOI: 10.1186/ar4313.Bouldouyre M-A, Cohen P, Guillevin L. Severe bronchospasm associated with rituximab for refractory Churg-Strauss syndrome. Ann Rheum Dis. 2009;68(4):606. DOI: 10.1136/ard.2008.093773.Bouldouyre M-A, Cohen P, Guillevin L. Severe bronchospasm associated with rituximab for refractory Churg-Strauss syndrome. Ann Rheum Dis. 2009;68(4):606. DOI: 10.1136/ard.2008.093773.Malm IJ, Mener DJ, Kim J, et al. Otolaryngological progression of granulomatosis with polyangiitis after systemic treatment with rituximab. Otolaryngol Head Neck Surg. 2014 Jan;150(1):68–72. DOI: 10.1177/0194599813509784. Epub 2013 Oct 23.Malm IJ, Mener DJ, Kim J, et al. Otolaryngological progression of granulomatosis with polyangiitis after systemic treatment with rituximab. Otolaryngol Head Neck Surg. 2014 Jan;150(1):68–72. DOI: 10.1177/0194599813509784. Epub 2013 Oct 23.Knight A, Hallenberg H, Baecklund E. Efficacy and safety of rit- uximab as maintenance therapy for relapsing granulomatosis with polyangiitis – a case series. Clin Rheumatol. 2013 Aug 20. DOI:10.1007/s10067-013-2351-y.Knight A, Hallenberg H, Baecklund E. Efficacy and safety of rit- uximab as maintenance therapy for relapsing granulomatosis with polyangiitis – a case series. Clin Rheumatol. 2013 Aug 20. DOI:10.1007/s10067-013-2351-y.

The authors declare that there are no conflicts of interest present.