medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-11-106-116medsovet-1550Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYБИОЛОГИЧЕСКАЯ ТЕРАПИЯ И ИНФЕКЦИИ У БОЛЬНЫХ РЕВМАТОИДНЫМ АРТРИТОМ СОВРЕМЕННЫЕ АСПЕКТЫBIOLOGICAL THERAPY AND INFECTION IN RHEUMATOID ARTHRITIS PATIENTS: MODERN ASPECTSБЕЛОВБ. С.BELOVB. S.

д.м.н.

MD

НАУМЦЕВАМ. С.NAUMTSEVAM. S.

к.м.н.

PhD in medicine

ТАРАСОВАГ. М.TARASOVAG. M.

д.м.н.

MD

БУХАНОВАД. В.BUKHANOVAD. V.Научно-исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияFSBSI Nasonova Scientific and Research Institute of RheumatologyRussian Federation201630122016011106116Copyright © 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://www.med-sovet.pro/jour/article/view/1550

В последние десятилетия в ревматологии отмечается явный прогресс, связанный с внедрением в практику генно-инженерных биологических препаратов (ГИБП). 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 т. ч. с летальным исходом. В настоящем обзоре проанализированы данные литературы, преимущественно последних 5 лет, касающиеся частоты и локализации инфекций у больных ревматоидным артритом при лечении различными 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 пневмококковой и противогриппозной) пациентов с аутоиммунными воспалительными ревматическими заболеваниями.

In the recent decades rheumatology has been witnessing the marked progress associated with introduction into clinical practice of gene engineering biological drugs. At the same time use of these drugs is associated with the increasing risk of development of infections of various nature and localization including opportunistic (invasive mycoses, pneumocystic pneumonia etc.) as well as the increased risk of reactivation of the latent infection, tuberculosis (TB), first of all. In addition to this, cases of grave infections (pneumonia, sepsis, bacterial arthritis, skin and soft tissue lesions etc.) are registered, including – with letal outcome. This review analyzes the literature data predominantly of the recent 5 years relating to frequency and localization of infections in rheumatoid arthritis patients at therapy by various GIBD. The importance of various infections (TB, pneumonias, chronic viral hepatitis, herpes-viral infections etc.) in the tactics of the specified patients follow-up is characterized. The necessity of a wider use of immunization by various vaccines (first of all, pneumococcal and anti-flu ones) of patients with autoimmune inflammatory rheumatic diseases is underlined.

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