rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2020-321-329rsp-2900Research ArticleОБЗОРЫИнтерлейкин 5 – новая мишень для терапии эозинофильного гранулематоза с полиангиитомINTERLEUKIN-5 IS A NEW TARGET IN THE TREATMENT OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIShttps://orcid.org/0000-0003-2641-9785БекетоваТ. В.BeketovaT. V.

Татьяна Валентиновна Бекетова 

115522, Москва, Каширское шоссе, 34А

tvbek@rambler.ruhttps://orcid.org/0000-0002-0710-7551АрсеньевЕ. В.ArsenievE. V.ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202024062020583321329Copyright © Бекетова Т.В., Арсеньев Е.В., 20202020Бекетова Т.В., Арсеньев Е.В.Beketova T.V., Arseniev E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2900

Интерлейкин 5 (ИЛ5) участвует в созревании и активации эозинофилов, его продукция повышена при эозинофильном гранулематозе с полиангиитом (ЭГПА). Эта редкая форма системных васкулитов (СВ) характеризуется периферической эозинофилией и поражением многих органов и систем. Внедрение в клиническую практику глюкокортикоидов (ГК) и цитостатиков значительно улучшило прогноз ЭГПА, но их применение сопряжено со значительными неблагоприятными реакциями и может быть недостаточно эффективно. При использовании стандартных схем лечения не всегда удается добиться ремиссии, сохраняется высокая частота рецидивов ЭГПА. Меполизумаб является антагонистом ИЛ5 и перспективным средством для лечения больных ЭГПА. В представленном обзоре литературы рассматриваются аргументы в пользу применения меполизумаба при ЭГПА и обсуждаются вопросы его эффективности и безопасности. Накопленные в настоящее время данные свидетельствуют об эффективности и безопасности меполизумаба у пациентов с ЭГПА, что было продемонстрировано в регистрационном двойном слепом рандомизированном плацебоконтролируемом исследовании MIRRA. Лечение антагонистом ИЛ5 позволяет контролировать как симптомы бронхиальной астмы, так и проявления СВ, повышает вероятность достижения ремиссии ЭГПА, может способствовать снижению риска рецидива, дает возможность минимизировать дозу ГК.

Interleukin-5 (IL-5) is involved in the maturation and activation of eosinophils, its production is increased in patients with eosinophilic granulomatosis with polyangiitis (EGPA). This rare form of systemic vasculitides (SV) is characterized by peripheral eosinophilia and involves multiple organs and systems. The clinical introduction of glucocorticoids (GCs) and immunosuppressants has considerably improved the prognosis of EGPA, but their use is associated with significant adverse reactions and cannot be effective enough. The use of standard treatment regimens cannot always allow to achieve remission; the rate of EGPA relapses remains high. Mepolizumab is an IL-5 antagonist and a promising drug for the treatment of patients with EGPA. The presented literature review considers arguments in favor of using mepolizumab in EGPA patients and discusses its efficacy and safety. The currently accumulated data suggest that mepolizumab is effective and safe in treating patients with EGPA, what has been demonstrated in the registration double-blind, randomized, placebo-controlled MIRRA study. Treatment with the IL-5 antagonist allows one to control both the symptoms of asthma and the manifestations of SV, enhances the probability of achieving remission of EGPA, can help reduce the risk of relapse and minimize the dose of GS.

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