medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-1-81-86medsovet-5544Research ArticleБРОНХОПУЛЬМОНОЛОГИЯ, ЛОРBRONCHOPULMONOLOGY, ENTМеполизумаб в терапии бронхиальной астмы у детейMepolizumab in the treatment of bronchial asthma in childrenhttps://orcid.org/0000-0002-0740-1718МизерницкийЮ. Л.MizernitskiyYu. L.

Мизерницкий Юрий Леонидович - доктор медицнских наук, профессор, заслуженный работник здравоохранения РФ, заведующий отделом хронических воспалительных и аллергических болезней легких Обособленного структурного подразделения Научно-исследовательский клинический институт педиатрии имени академика Ю.Е. Вельтищева.

125412, Москва, ул. Талдомская, д. 2

Yuriy L. Mizernitskiy - Dr. of Sci. (Med), professor, Honored Worker of Healthcare of the Russian Federation, Head of the Department of Chronic Inflammatory and Allergic Lung Diseases of the Separate Structural Subdivision The Research and Clinical Institute for Pediatrics named after Academician Yuri Veltischev.

yulmiz@mail.ruhttps://orcid.org/0000-0002-3621-8875МельниковаИ. М.Mel'nikovaI. M.

Мельникова Ирина Михайловна - доктор медицнских наук, профессор, заведующая кафедрой педиатрии №1.

150000, Ярославль, ул. Революционная, д. 5

Irina M. Mel’nikova - Dr. of Sci. (Med), professor, head of the Department of Pediatrics No. 1.

5, Revolutsionnaya St., Yaroslavl, 150000

imyar@mail.ruПавленкоВ. А.PavlenkoV. A.

Павленко Василиса Александровна - кандидат медицнских наук, ассистент кафедры педиатрии №1.

150000, Ярославль, ул. Революционная, д. 5

Vasilisa A. Pavlenko, Cand. of Sci. (Med), assistant professor of the Department of Pediatrics No. 1.

5, Revolutsionnaya St., Yaroslavl, 150000

grvasilisa@mail.ruНаучно-исследовательский клинический институт педиатрии имени академика Ю.Е. Вельтищева Российского национального исследовательского медицинского университета имени Н.И. ПироговаРоссияThe Research and Clinical Institute for Pediatrics named after Academician Yuri Veltischev of the Pirogov Russian National Research Medical UniversityRussian FederationЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation202008032020018186Copyright © Мизерницкий Ю.Л., Мельникова И.М., Павленко В.А., 20202020Мизерницкий Ю.Л., Мельникова И.М., Павленко В.А.Mizernitskiy Y.L., Mel'nikova I.M., Pavlenko V.A.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/5544

Тяжелая бронхиальная астма в детском возрасте остается серьезной проблемой, что обусловлено высоким риском летальности, побочными эффектами терапии высокими дозами глюкокортикостероидов, значительным потреблением ресурсов здравоохранения. В статье приводятся современные сведения о патогенетических механизмах бронхиальной астмы, в частности об участии интерлейкина-5 (ИЛ-5) в развитии эозинофильного воспаления. Данные исследований свидетельствуют о безопасности и эффективности использования антиИЛ-5-терапии в качестве дополнения к стандартному лечению при тяжелой эозинофильной БА и плохом ее контроле, в т. ч. в детском возрасте. Меполизумаб является наиболее широко исследованным антиИЛ-5-моноклональным препаратом. Он статистически значимо снижает уровень эозинофилии в органах, тканях-мишенях, уменьшает частоту обострений и госпитализаций, способствует существенному сокращению потребности в поддерживающей терапии глюкокортикостероидами. Высокий профиль эффективности и безопасности меполизумаба, полученный в результате рандомизированных контролируемых клинических исследований, делает его препаратом выбора при лечении детей 6 лет и старше с тяжелой эозинофильной БА. Однако необходимы дальнейшие постмаркетинговые исследования биомаркеров для оценки ответа на лечение антиИЛ-5-препаратами, определения оптимальной продолжительности и долгосрочных эффектов лечения, риска рецидива при отмене у детей с БА, особенно в возрасте до 12 лет.

Severe bronchial asthma in children remains a serious problem, which is due to the high risk of mortality, side effects of therapy with high doses of glucocorticosteroids, significant consumption of health resources. The article presents modern data on the pathogenetic mechanisms of bronchial asthma, in particular, on the participation of interleukin-5 (IL-5) in the development of eosinophilic inflammation. Research data demonstrate the safety and effectiveness of anti-IL-5 therapy as a supplement to standard treatment for severe eosinophilic BA and its poor control, including in children. Mepolizumab is the most widely researched anti-IL-5-monoclonal drug. It statistically significantly reduces the level of eosinophilia in the organs, target tissues, reduces the frequency of exacerbations and hospitalizations, significantly reduces the need for maintenance therapy with glucocorticosteroids. The high profile of efficacy and safety of mepolizumab obtained as a result of randomized controlled clinical trials makes it a drug of choice in the treatment of children aged 6 and older with severe eosinophilic BA. However, further post-marketing biomarker studies are required to evaluate the response to anti-IL-5 drugs treatment, to determine the optimal duration and long-term effects of treatment, the risk of relapse in case of withdrawal in children with BA, especially those under 12 years of age.

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