rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2020-743-746rsp-2976Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONSЭффективность ингибитора интерлейкина-6 тоцилизумаба при артериите Такаясу с недостаточным ответом на предшествующее лечение глюкокортикоидами, метотрексатом, циклофосфаном, флударабином (Клиническое наблюдение)The efficacy of interleukin-6 inhibitor tocilizumab for takayasu’s arteritis, after insufficient response to previous treatment with glucocorticoids, methotrexate, cyclophosphamide, fludarabine. (A case report)https://orcid.org/0000-0003-1559-4721АнтиповаВ. Н.AntipovaV. N.

430005,  Республика Мордовия, Саранск, ул. Большевистская, 68

Valentina N. Antipova

430005, Saransk, Bolshevistskaya str., 68, Republic of Mordovia

https://orcid.org/0000-0002-2786-7267СолодовниковаЛ. В.SolodovnikovaL. V.

430013, Республика Мордовия, Саранск, ул. Победы, 14/5, корп. 1

Larisa V. Solodovnikova

430013, Saransk, Pobedy str., 14/5, building 1, Republic of Mordovia

https://orcid.org/0000-0003-2641-9785БекетоваТ. В.BeketovaT. V.

115522, Москва, Каширское шоссе, 34А

Tatiana V. Beketova

115522, Moscow, Kashirskoye Highway, 34A

tvbek@rambler.ruФГБОУ ВО Национальный исследовательский Мордовский государственный университет им. Н.П. ОгареваРоссияNational Research Ogarev Moldovia State UniversityRussian FederationГБУЗ РМ Мордовская республиканская центральная клиническая больницаРоссияMordovia Republican Central Clinical HospitalRussian FederationФГБНУ Научноисследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202014012021586743746Copyright © Антипова В.Н., Солодовникова Л.В., Бекетова Т.В., 20212021Антипова В.Н., Солодовникова Л.В., Бекетова Т.В.Antipova V.N., Solodovnikova L.V., Beketova T.V.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/2976

Прогресс в ревматологии, прежде всего, связан с внедрением генно-инженерных биологических препаратов (ГИБП), которые демонстрируют преимущества перед стандартными методами лечения в отношении как эффективности, так и безопасности. При артериите Такаясу вопросы применения ГИБП не разработаны. Среди перспективных направлений лечения рефрактерного артериита Такаясу рассматривают ингибирование интерлейкина (ИЛ)-6. Представлен собственный опыт эффективного применения тоцилизумаба (гуманизированные моноклональные антитела к ИЛ-6 рецептору) у пациентки 27 лет с артериитом Такаясу, резистентным к лечению глюкокортикоидами и цитостатиками (циклофосфан, метотрексат), неполным эффектом альтернативной терапии флударабином, непереносимостью циклофосфана и осложнениями лечения глюкокортикоидами. В результате лечения тоцилизумабом (600 мг внутривенно каждые 4 недели в течение 24-х месяцев) достигнута стойкая ремиссия артериита Такаясу, подтвержденная результатами позитронной эмиссионной томографии, и минимизирована доза глюкокортикоидов. Применение ГИБП, действие которых направлено на ингибирование ИЛ-6, можно рассматривать как перспективную инновационную стратегию лечения артериита Такаясу, в первую очередь при неэффективности стандартной терапии или ее плохой переносимости.

Thanks to progress in understanding of Takayasu’s arteritis pathogenesis, the role of biological therapies is expanding, especially in refractory diseases. Robust data are still lacking to draw conclusions concerning the use of interleukin (IL)-6 inhibitors in Takayasu’s arteritis. The article presents own experience of the use of tocilizumab (TCZ) for Takayasu’s arteritis after insufficient response to previous treatment with glucocorticoids, methotrexate, cyclophosphamide, fludarabine and intolerance of cyclophosphamide, glucocorticoids. As result of TCZ treatment (600 mg IV every 4 weeks for 24 months), a stable Takayasu’s arteritis remission was achieved and confirmed by fluorodeoxyglucose-positron emission tomography.

The inhibition of IL-6 can be considered as a promising innovative strategy for the treatment of Takayasu’s arteritis, primarily with insufficient response, intolerance or contraindications to standard therapy.

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