Коморбидные инфекции при спондилоартритах: современный взгляд на проблему

В обзоре рассматривается проблема коморбидных инфекций (КИ) при анкилозирующем спондилите и псориатическом артрите (ПсА) как основных нозологических формах спондилоартритов (СпА). Проанализирована частота КИ на фоне терапии генно-инженерными биологическими препаратами и таргетными синтетическими базисными противовоспалительными препаратами. Сделано заключение, что проблема КИ при СпА заслуживает самого пристального внимания.
Показано значение превентивных мероприятий в отношении КИ при лечении СпА. В частности, отмечено, что в соответствии с обновленными рекомендациями ЕULAR и других научных ревматологических ассоциаций всем больным с иммуновоспалительными ревматическими заболеваниями (включая СпА), получающим иммуносупрессивную терапию, рекомендуется иммунизация гриппозной и пневмококковой вакцинами из-за высокого риска летальных исходов, обусловленных инфекционной патологией дыхательных путей. При этом вакцинация показана даже больным с ожидаемым субоптимальным ответом. Приведены основные пункты рекомендаций медицинского совета Национального фонда борьбы с псориазом (Пс) по применению рекомбинантной вакцины против инфекции Herpes zoster (RHZV) у больных Пс/ПсА.
Необходимы дальнейшие исследования частоты и структуры КИ, а также влияния новых методов терапии на распространенность КИ у больных СпА. Важным направлением будущих исследований должно стать определение эффективности и безопасности вакцинации у данного контингента больных.

спондилоартриты, анкилозирующий спондилит, псориатический артрит, коморбидные инфекции, генно-инженерные биологические препараты, таргетные синтетические базисные противовоспалительные препараты, вакцинация

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