rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-1rsp-3242Research ArticleПЕРЕДОВАЯLEADING ARTICLEИнтерстициальные заболевания легких при ревматоидном артрите: мультидисциплинарная проблема ревматологии и пульмонологииInterstitial lung disease in rheumatoid arthritis: A multidisciplinary problem in rheumatology and pulmonologyhttps://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovE. L.

Насонов Евгений Львович

115522, Москва, Каширское шоссе, 34а

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

Evgeny Nasonov

115522, Moscow, Kashirskoye Highway, 34A

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

nasonov@irramn.ruhttps://orcid.org/0000-0002-3248-6426АнаньеваЛ. П.AnanyevaL. P.

115522, Москва, Каширское шоссе, 34а

 115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

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

 115522, Moscow, Kashirskoye Highway, 34A

ФГБНУ «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 FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Russian Federation202224122022606517534Copyright © Насонов Е.Л., Ананьева Л.П., Авдеев С.Н., 20222022Насонов Е.Л., Ананьева Л.П., Авдеев С.Н.Nasonov E.L., Ananyeva L.P., Avdeev S.N.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/3242

Ревматоидный артрит (РА) – иммуновоспалительное ревматическое заболевание (ИВРЗ), характеризующееся хроническим эрозивным артритом и системным поражением внутренних органов, приводящее к ранней инвалидности и сокращению продолжительности жизни пациентов. Особенно важное место среди системных проявлений РА занимают интерстициальные заболевания легких (ИЗЛ) – наиболее тяжелая форма легочной патологии при РА, определяемая как РА-ИЗЛ, которая патогенетически связана с факторами риска (курение и др.) и аутоиммунными механизмами, лежащими в основе РА. РА-ИЗЛ, представляет собой субтип РА, характеризующийся тяжелым течением и неблагоприятным прогнозом. В обзоре представлены новые данные, касающиеся факторов риска и биомаркеров РА-ИЗЛ; современные возможности диагностики, основанные на применении функциональных легочных тестов, компьютерной томографии высокого разрешения, ультразвукового исследования легких. Особое внимание уделено эффективности и безопасности фармакотерапии, включая метотрексат, генно-инженерные биологические препараты, ингибиторы JAK и антифиброзную терапию. Предложен алгоритм фармакотерапии РА-ИЗЛ.

Rheumatoid arthritis (RA) is an immune-mediated rheumatic disease (IMRDs) characterized by chronic erosive arthritis and systemic damage to internal organs, leading to early disability and reduced life expectancy in patients. A particularly important place among the systemic manifestations of RA is occupied by interstitial lung diseases (ILD) – the most severe form of pulmonary pathology in RA, defined as RA-ILD, which is pathogenetically associated with risk factors (smoking, etc.) and autoimmune mechanisms underlying RA. RA-ILD is a subtype of RA characterized by a severe course and a poor prognosis. The review presents new data regarding risk factors and biomarkers for RA-ILD; modern diagnostic capabilities based on the use of functional lung tests, high-resolution computed tomography, ultrasound examination of the lungs. Particular attention is paid to the efficacy and safety of pharmacotherapy, including methotrexate, biologics, JAK inhibitors, and antifibrotic therapy. An algorithm for the pharmacotherapy of RA-ILD has been proposed.

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