rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-21-31rsp-3112Research ArticleПРОБЛЕМЫ РЕВМАТОЛОГИИ В ПЕРИОД ПАНДЕМИИ КОРОНОВИРУСНОЙ БОЛЕЗНИ 2019PROBLEMS OF RHEUMATOLOGY DURING THE 2019 CORONAVIRUS PANDEMICВакцинация против SARS-CoV-2 при ревматических заболеваниях: вопросы безопасностиVaccination against SARS-CoV-2 in rheumatic diseases: Safety issueshttps://orcid.org/0000-0001-7091-2054БеловБ. С.BelovB. S.

Белов Борис Сергеевич

115522, Москва, Каширское шоссе, 34а

 

Boris Belov

115522, Moscow, Kashirskoye Highway, 34A

belovbor@yandex.ruhttps://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34а

125993, Москва, ул. Баррикадная, 2/1, стр. 1

Alexander M. Lila

115522, Moscow, Kashirskoye Highway, 34A

125993, Moscow, Barrikadnaya str., 2/1, building 1

https://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovE. L.

115522, Москва, Каширское шоссе, 34а

119991, Москва, ул. Трубецкая, 8, стр. 2

Evgeny L. Nasonov

115522, Moscow, Kashirskoye Highway, 34A

119991, Moscow, Trubetskaya str., 8, building 2

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияV.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Russian Federation20222702202260121–31Copyright © Белов Б.С., Лила А.М., Насонов Е.Л., 20222022Белов Б.С., Лила А.М., Насонов Е.Л.Belov B.S., Lila A.M., 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/3112

Проблема коронавирусной болезни 2019 (COVID-19, coronavirus disease 2019) спустя два года по-прежнему остается актуальной как в социальном, так и в медицинском плане. В качестве одного из методов борьбы с текущей пандемией COVID-19 большинство экспертов делают ставку на широкое использование вакцинации. Однако применение вакцин против SARS-CoV-2 у больных ревматическими заболеваниями (РЗ) поднимает ряд вопросов, связанных с эффективностью, иммуногенностью, а также с безопасностью иммунизации, включая нивелирование рисков обострения основного заболевания или развития новых аутоиммунных феноменов. Исходя из этого весьма важен анализ данных по вышеназванным аспектам в режиме реального времени, особенно с учетом того, что пациенты ревматологического круга были исключены из программ клинической разработки вакцин против SARS-CoV-2. В настоящем обзоре представлены результаты исследований последнего года по проблеме безопасности вакцинации против COVID-19 у больных РЗ. Дана краткая характеристика основных антиковидных вакцин. Поствакцинальные нежелательные явления были достаточно частыми после первой, второй или обеих доз вакцин у пациентов с РЗ, что согласуется с данными, полученными в общей популяции. В целом частота обострения РЗ после вакцинации против COVID-19 представляется достаточно низкой (5–7%) и не имеет статистически значимых ассоциаций с конкретной вакциной или проводимой противоревматической терапией. В то же время однозначная интерпретация этих данных затруднена как минимум по трем причинам: а) во многих исследованиях учитывались только симптомы, развивающиеся после первой дозы вакцины; б) ограниченный во времени поствакцинальный период наблюдения; в) значительные расхождения в трактовке обострений заболевания. В рамках рассматриваемой проблемы имеются еще очень много вопросов, ответы на которые должны быть получены в крупных проспективных контролируемых исследованиях.

The problem of coronavirus disease 2019 (Coronavirus diseases, COVID-19) two years later still remains relevant both socially and medically. As one of the methods of combating the current COVID-19 pandemic, most experts rely on the widespread use of vaccination. However, the use of vaccines against SARS-CoV-2 in patients with rheumatic diseases (RD) raises a number of issues related to the effectiveness, immunogenicity, and safety of immunization, including leveling the risks of exacerbation of the underlying disease or the development of new autoimmune phenomena. For this reason it is very important to analyze data on the above-mentioned aspects in real time, especially given that patients of the rheumatology circle were excluded from the clinical development programs of vaccines against SARS-CoV-2. This review presents the results of last year’s research on the safety of vaccination against COVID-19 in patients with RS. A brief description of the main anticovedic vaccines is given. Post-vaccination adverse events were quite frequent after the first, second or both doses of vaccines in patients with RS, which is consistent with the data obtained in the general population. In general, the frequency of exacerbation of RD after vaccination against COVID-19 seems to be quite low (5–7%) and has no significant associations with a specific vaccine or anti-rheumatic therapy. At the same time, unambiguous interpretation of these data is difficult for at least three reasons: a) in many studies, only the symptoms developing after the first dose of the vaccine were taken into account; b) the time-limited post-vaccination follow-up period; c) significant discrepancies in the interpretation of exacerbations of the disease. Within the framework of the problem under consideration, there are still a lot of questions, the answers to which should be obtained in large prospective controlled studies.

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