Интерлейкин 5 – новая мишень для терапии эозинофильного гранулематоза с полиангиитом

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.

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