References

rsp

Научно-практическая ревматология

Rheumatology Science and Practice

1995-44841995-4492

IMA-PRESS, LLC

10.14412/1995-4484-2014-322-330

rsp-1947

Research Article

ОБЗОР

REVIEW

Терапия генно-инженерными биологическими препаратами и инфекции у больных ревматоидным артритом: актуальность и перспективы

BIOLOGICAL THERAPY AND INFECTIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS: RELEVANCE AND PROSPECTS

Белов

Б. С.

Belov

B. S.

belovbor@yandex.ru

ФГБУ «Научно- исследовательский институт ревматологии им. В.А. Насоновой» РАН, Москва, РоссияРоссияNasonova Research Institute of Rheumatology, Moscow, RussiaRussian Federation

2014

23062014

523

№3 (2014)

322330

2014

Белов Б.С.

Belov B.S.

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/1947

В последние десятилетия в ревматологии отмечается явный прогресс, связанный с внедрением в практику генно-инженерных биологических препаратов (ГИБП). В то же время применение этих препаратов ассоции- руется с нарастающим риском развития инфекций разнообразной природы и локализации, включая оппорту- нистические (инвазивные микозы, пневмоцистная пневмония и др.), а также с повышенным риском реакти- вации латентной инфекции, в первую очередь туберкулеза. Помимо этого, регистрируются случаи тяжелых инфекций (пневмония, сепсис, бактериальный артрит, поражение кожи и мягких тканей и др.), в том чис- ле с летальным исходом. В настоящем обзоре проанализированы данные литературы, преимущественно пос- ледних 3 лет, касающиеся частоты и локализации инфекций при лечении различными ГИБП, полученные в рамках плацебоконтролируемых и прямых сравнительных исследований у больных ревматоидным артри- том. Охарактеризована значимость различных инфекций (туберкулез, пневмонии, хронические вирусные ге- патиты, герпесвирусные инфекции и др.) в тактике курации указанных больных. Подчеркнута необходимость более широкого применения иммунизации различными вакцинами (в первую очередь, пневмококковой и противогриппозной) пациентов с аутоиммунными воспалительными ревматическими заболеваниями.

The past decades are marked by the obvious progress in rheumatology, which is related to the practical introduction of biological agents. At the same time the use of these drugs is associated with the increasing risk of infections of different nature and locations, including opportunistic ones (invasive mycoses, Pneumocystis pneumonia, etc.), and with the greater risk of reactivation of latent infection, primary with that of tuberculosis. Beyond that point, there are cases of severe infections (pneumonia, sepsis, bacterial arthritis, skin and soft tissue lesions, etc.), including those with a fatal outcome. This review analyzes mainly the past 3-year literature data on the rate and location of infections treated with biologics, which have been obtained in the placebo-controlled and direct comparative studies of patients with rheuma- toid arthritis. It characterizes the importance of different infections (tuberculosis, pneumonia, chronic viral hepati- tides, herpesvirus infections, etc.) for treatment policy in the above patients. This underlines the need for wider immu- nization with different vaccines (chiefly against pneumococcus and influenza) in patients with autoimmune inflam- matory rheumatic diseases.

ревматоидный артритгенно-инженерные биологические препаратыинфекциивакцина- ция.

rheumatoid arthritisbiological agentsinfectionsvaccination.

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