mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2016-4-4-15mrj-712Research ArticleЛЕКЦИИLECTURESТАРГЕТНАЯ ТЕРАПИЯ И ИНФЕКЦИИ ПРИ РЕВМАТИЧЕСКИХ ЗАБОЛЕВАНИЯХTARGETED THERAPY AND INFECTIONS IN RHEUMATIC DISEASESБеловБ. С.BelovB. S.

Контакты: Борис Сергеевич Белов; ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», 115522, Москва, Каширское шоссе, 34A

Contact: Boris Sergeevich Belov; V.A. Nasonova Research Institute of Rheumatology,  34A, Kashirskoe Shosse, Moscow 115522

belovbor@yandex.ruНаумцеваМ. С.NaumtsevaM. S.ТарасоваГ. М.TarasovaG. M.БухановаД. В.BukhanovaD. V.Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation201615122016104415Copyright © Белов Б.С., Наумцева М.С., Тарасова Г.М., Буханова Д.В., 20162016Белов Б.С., Наумцева М.С., Тарасова Г.М., Буханова Д.В.Belov B.S., Naumtseva M.S., Tarasova G.M., Bukhanova D.V.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/712

В последние десятилетия в ревматологии отмечается явный прогресс, связанный с внедрением в практику генно-инженерных биологических препаратов (ГИБП) и таргетных синтетических противовоспалительных препаратов. В то же время применение этих препаратов ассоциируется с нарастающим риском развития инфекций разнообразной природы и локализации, включая оппортунистические (инвазивные микозы, пневмоцистная пневмония и др.), а также повышенный риск реактивации латентной инфекции, в первую очередь туберкулеза (ТБ). Помимо этого регистрируются случаи тяжелых инфекций (пневмония, сепсис, бактериальный артрит, поражение кожи и мягких тканей и др.), в том числе с летальным исходом. В статье проанализированы данные литературы (преимущественно за последние 5 лет), касающиеся частоты и локализации инфекций у больных ревматологического профиля при лечении ГИБП. Охарактеризована значимость различных инфекций (ТБ, пневмонии, хронические вирусные гепатиты, герпес-вирусные инфекции и др.) в тактике курации указанных больных. Подчеркнута необходимость более широкого применения иммунизации различными вакцинами (в первую очередь против гриппа и пневмококковой инфекции) пациентов с аутоиммунными воспалительными ревматическими заболеваниями.

In the past decade, rheumatology has shown clear progress in the practical introduction of biological agents (BAs) and targeted sintetic anti-inflammatory agents. At the same time, the use of these agents is associated with an increasing risk for infections of different origin and sites, including opportunistic infections (invasive my-coses, Pneumocystis pneumonia, etc.), as well as an increased risk for reactivation of latent infections, primarily tuberculosis (TB). In addition, there are cases of severe infections (pneumonia, sepsis, bacterial arthritis, skin and soft tissue lesions, etc.), including those with a fatal out-come. The review analyzes the literature data (mainly in the last 5 years) regarding the frequency and localization of infections in rheumatologic patients treated with BAs. It characterizes the significance of various infections (TB, pneumonia, chronic viral hepatitis, herpesvirus infection, etc.) in the tactics of following up these patients. The authors emphasize the need for the more widespread use of various vaccines (especially those against influenza and pneumococcal infection) in patients with autoimmune inflammatory rheumatic diseases.

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