Интерстициальные заболевания легких при ревматоидном артрите: мультидисциплинарная проблема ревматологии и пульмонологии

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.

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