mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-4-94-100mrj-1177Research ArticleОБЗОРЫREVIEWSПерспективы применения белимумаба при волчаночном нефритеProspects for the use of belimumab in lupus nephritishttps://orcid.org/0000-0002-4275-0315КозловскаяН. Л.KozlovskayaN. L.

Наталья Львовна Козловская

117198, Москва, ул. Миклухо-Маклая, 6129327, Москва, ул. Ленская, 15

Natalya Lvovna Kozlovskaya

6, Miklukho-Maklaya St., Moscow 11719815, Lenskaya St., Moscow 129327

nkozlovskaya@yandex.ruhttps://orcid.org/0000-0002-5206-1732СоловьевС. К.SolovievS. K.

123056, Москва, Грузинский переулок, 3А

3A, Gruzinskiy Lane, Moscow 123056

https://orcid.org/0000-0002-1663-7810АсееваЕ. А.AseevaE. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГАОУ ВО «Российский университет дружбы народов»; ГБУЗ г. Москвы «Городская клиническая больница им. А.К. Ерамишанцева Департамента здравоохранения города Москвы»РоссияPeoples' Friendship University of Russia; «A.K. Yeramishantsev City Clinical hospital of Moscow City Health Department»Russian FederationАО «Группа компаний МЕДСИ»РоссияJSC Group of companies MEDSIRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation20211508202115494100Copyright © Козловская Н.Л., Соловьев С.К., Асеева Е.А., 20212021Козловская Н.Л., Соловьев С.К., Асеева Е.А.Kozlovskaya N.L., Soloviev S.K., Aseeva E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1177

За последние 50 лет удалось существенно улучшить выживаемость больных системной красной волчанкой (СКВ), однако необходимо создание нового поколения препаратов для терапии волчаночного нефрита (ВН), развитие которого не менее чем у 50% больных СКВ является одним из основных факторов высокого риска летальности. Международное клиническое исследование BLISS-LN продемонстрировало высокую частоту достижения и сохранения почечного ответа (ПО), подтвержденную более высокой частотой достижения ПО первичной эффективности и полного почечного ответа при применении белимумаба (БЛМ) в дополнение к стандартной терапии (СТ) по сравнению с одной СТ у пациентов с волчаночным нефритом (ВН). При применении БЛМ наблюдалось статистически значимое снижение риска развития нежелательных явлений со стороны почек (в частности, ухудшения функции почек) или смертельного исхода в течение 104 нед по сравнению с плацебо. Улучшение исходов ВН было достигнуто в условиях долгосрочного уменьшения применения глюкокортикоидов после индукционной фазы. При терапии БЛМ отмечалось также снижение общей активности СКВ, уменьшение числа тяжелых обострений и улучшение показателей серологических маркеров. Соотношение «польза/риск» при использовании БЛМ в сочетании со СТ для лечения ВН было благоприятным. БЛМ может быть рекомендован для терапии ВН в комбинации со стандартными методами лечения с целью достижения и поддержания ремиссии.

Over the past 50 years the survival rate of patients with systemic lupus erythematosus (SLE) significantly improved, however, it is necessary to develop a new generation of drugs for the treatment of lupus nephritis (LN), the development of which is one of the main factors of high mortality risk in at least 50% of SLE patients. The international clinical trial BLISS-LN has demonstrated a high rate of achievement and maintenance of renal response (RR), confirmed by a higher rate of achievement of RR primary efficacy and complete renal response when using belimumab (BLM) in addition to standard therapy (ST) compared to ST alone in patients with LN. When using BLM, there was a statistically significant reduction in the risk of developing adverse renal events (in particular, deterioration of renal function) or death within 104 weeks compared with placebo. Improvement in LN outcomes was achieved in the setting of long-term reduction in glucocorticoids use after the induction phase. With BLM therapy, there was also a decrease in the total activity of SLE, a decrease in the number of severe exacerbations, and an improvement in serological markers. The benefit/risk ratio of BLM in combination with ST for LN treatment was favorable. BLM can be recommended for LN therapy in combination with standard treatment methods in order to achieve and maintain remission.

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