mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2024-5-107-115mrj-1647Research ArticleОБЗОРЫREVIEWSСтероидсберегающая стратегия терапии васкулита, ассоциированного с антинейтрофильными цитоплазматическими антителамиSteroid-sparing strategy for the treatment of vasculitis associated with antineutrophil cytoplasmic antibodieshttps://orcid.org/0000-0002-4846-5531ЕгороваО. Н.EgorovaO. N.

Ольга Николаевна Егорова

115522, Москва, Каширское шоссе, 34А

Olga Nikolaevna Egorova

34A, Kashirskoe Shosse, Moscow 115522

onegorova@yandex.ruhttps://orcid.org/0000-0001-9933-5350ТарасоваГ. М.TarasovaG. M.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0003-3051-219XДацинаА. В.DatsinaA. V.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-4630-3985ИсаеваБ. Г.IssayevaB. G.

050012, Алматы, ул. Толе би, 94

94, Tole bi Street, Almaty 050012

https://orcid.org/0000-0001-9482-1878ДильмановаД. С.DilmanovaD. S.

050012, Алматы, ул. Толе би, 94

94, Tole bi Street, Almaty 050012

https://orcid.org/0000-0002-0020-8464ИсаеваС. М.IssayevaS. M

050012, Алматы, ул. Толе би, 94

94, Tole bi Street, Almaty 050012

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34А; 125993, Москва, ул. Баррикадная, 2/1, стр. 1

34A, Kashirskoe Shosse, Moscow 115522; 2/1, Barrikadnaya Street, Build. 1, Moscow 125993

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationНАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова»КазахстанKazakh National Medical University named after S.D. AsfendiyarovKazakhstanФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; кафедра ревматологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian Federation202420102024185107115Copyright © Егорова О.Н., Тарасова Г.М., Дацина А.В., Исаева Б.Г., Дильманова Д.С., Исаева С.М., Лила А.М., 20242024Егорова О.Н., Тарасова Г.М., Дацина А.В., Исаева Б.Г., Дильманова Д.С., Исаева С.М., Лила А.М.Egorova O.N., Tarasova G.M., Datsina A.V., Issayeva B.G., Dilmanova D.S., Issayeva S.M., Lila A.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1647

Терапия васкулитов, ассоциированных с антинейтрофильными цитоплазматическими антителами (АНЦА), традиционно проводилась глюкокортикоидами (ГК) и иммунодепрессантами (ИД), что нередко провоцировало развитие инфекции, сахарного диабета и других нежелательных явлений (НЯ). Разработка стероидсберегающей стратегии с применением генно-инженерных биологических (ГИБП, в том числе ритуксимаба и др.) и синтетических таргетных (авакопан) препаратов радикально улучшила течение заболевания. В настоящее время появляется все больше фундаментальных и клинических исследований многочисленных ГИБП, которые эффективно уменьшают проявления НЯ, связанных с ГК и ИД. Стероидсберегающая стратегия терапии не только демонстрирует значительную эффективность, но и открывает новые перспективы лечения пациентов с АНЦА-ассоциированными системными васкулитами.

Glucocorticoids (GC) and immunosuppressants (IS) are traditional treatments for vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA), often resulting in the development of infections, diabetes mellitus and other adverse events (AEs). The development of a steroid-sparing strategy using biologic disease-modifying antirheumatic drugs (bDMARDs, including rituximab, etc.) and synthetic targeted drugs (avacopan) has radically improved the course of the disease. Currently, there are increasing number of basic and clinical trials of numerous bDMARDs that effectively reduce the number of AEs associated with GC and IS. The steroid-sparing therapeutic strategy not only shows considerable efficacy, but also opens up new perspectives for the treatment of patients with ANCA-associated systemic vasculitis.

васкулитыассоциированные с антинейтрофильными цитоплазматическими антителамистероидсберегающая терапияглюкокортикоидыиммунодепрессантыгенно-инженерные биологические препаратыритуксимабавакопанvasculitis associated with antineutrophil cytoplasmic antibodiessteroid-sparing therapyglucocorticoidsimmunosuppressantsgenetically engineered biological drugsrituximabavacopanСтатья подготовлена в рамках научно-исследовательской работы (государственное задание № РК 122040400024-7) и международного научного сотрудничества ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой» (Россия) и НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова» (Казахстан). Исследование не имело спонсорской поддержки.The article was prepared within the framework of research work (state assignment № PK 122040400024-7) and international scientific cooperation of V.A. Nasonova Research Institute of Rheumatology (Russia) and the Kazakh National Medical University named after S.D. 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The authors declare that there are no conflicts of interest present.