mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2014-2-21-27mrj-545Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ТЕРАПИИ РЕВМАТОИДНОГО АРТРИТАURGENT PROBLEMS IN TREATMENT OF RHEUMATOID ARTHRITISПроблема коморбидных инфекций у больных ревматоидным артритомComorbid infections in patients with rheumatoid arthritisБеловБ.С.BelovB.S.1@ru.ruФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой» РАМН, Москва, РоссияРоссияV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, Moscow, RussiaRussian Federation201408052014822127Copyright © Белов Б., 20142014Белов Б.Belov B.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/545

Проблема коморбидных инфекций (КИ) по-прежнему актуальна для современной ревматологии. Это связано как с наличием аутоиммунного ревматического заболевания, так и с необходимостью применения препаратов с иммуносупрессивным действием.

В статье рассмотрены некоторые вопросы КИ в рамках рекомендаций EULAR (2013) по лечению ревматоидного артрита (РА). Проанализирована частота КИ при лечении различными базисными противовоспалительными и генно-инженерными биологическими препаратами. Показано значение превентивных мероприятий в отношении КИ при лечении РА.

Подчеркнута важность иммунизации (в первую очередь противогриппозными и пневмококковыми вакцинами) больных РА с целью снижения частоты инфекций нижних дыхательных путей и риска летального исхода от них. Вакцинацию следует применять даже в случаях с ожидаемым субоптимальным эффектом. 

The problem of comorbid infections (CI) in modern rheumatology remains important. The reasons behind it include the presence of an autoimmune rheumatic disease and the need to use immunosuppressant drugs. We discuss some problems of CI under EULAR recommendations (2013) for the management of rheumatoid arthritis (RA). The incidence rates of comorbid infections in patients treated with different disease- modifying anti-rheumatic and biological drugs are analyzed. The significance of measures for preventing CI in management of RA patients is demonstrated. The significance of vaccination (first of all, with anti-influenza and pneumococcal vaccines) of RA patients to reduce the incidence rate of lower respiratory tract infections and the risk of infection-related mortality is emphasized. Vaccination is recommended even if suboptimal outcome is expected. 

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