Внутривенный иммуноглобулин в ревматологии: новые данные и проект клинических рекомендаций

Системные аутоиммунные ревматические заболевания (САРЗ) – клинико-иммунологические синдромы, характеризующиеся развитием как уникальных, так и общих (частично перекрещивающихся) клинических и патологических проявлений, разнообразием вариантов течения и прогрессирования, «ответа» на противовоспалительную терапию и тяжести «коморбидной» патологии. В спектре препаратов, применяющихся для лечения САРЗ, определенные позиции уже более 50 лет занимает внутривенный иммуноглобулин (ВИГ), другим не менее важным показанием для назначения которого является заместительная терапия при первичных (inborn errors of immunity) и вторичных иммунодефицитах. Фактически ВИГ является прототипом «биологических агентов», предшествующим разработке моноклональных антител (мАТ) для лечения заболеваний человека. В нарративном обзоре рассматриваются новые данные, касающиеся эффективности и безопасности ВИГ при САРЗ; значение ВИГ в заместительной терапии у пациентов с гипогаммглобулинемией, в первую очередь связанной с анти-В-клеточной терапией. Представлен проект клинических рекомендаций, касающихся применения ВИГ для лечения САРЗ.

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