medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-065medsovet-9189Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESБиологическая терапия тяжелой бронхиальной астмы у детей: показания и критерии эффективностиBiological therapy of severe bronchial asthma in children: Indications and effectiveness criteriahttps://orcid.org/0000-0002-2603-0051БуйноваС. Н.BuynovaS. N.

Буйнова Светлана Николаевна, к.м.н., доцент кафедры клинической аллергологии и пульмонологии

664049, Иркутск, мкр. Юбилейный, д. 100

Svetlana N. Buynova, Cand. Sci. (Med.), Associate Professor of the Department of Clinical Allergology and Pulmonology

100, Yubileiny Microdistrict, Irkutsk, 664049

33s1@rambler.ruhttps://orcid.org/0000-0002-3417-0425ШинкареваВ. М.ShinkarevaV. M.

Шинкарева Вера Михайловна, врач отделения эндокринологии

664003, Иркутск, бульвар Гагарина, д. 4

Vera M. Shinkareva, Doctor of the Department of Endocrinology

4, Gagarin Boulevard, Irkutsk, 664003

shinkareva@igodkb.ruhttps://orcid.org/0000-0003-2742-3794ТрофименкоИ. Н.TrofimenkoI. N.

Трофименко Ирина Николаевна, д.м.н., доцент, заведующая кафедрой клинической аллергологии и пульмонологии

664049, Иркутск, мкр. Юбилейный, д. 100

Irina N. Trofimenko, Dr. Sci. (Med.), Associate Professor, Head of the Department of Clinical Allergology and Pulmonology

100, Yubileiny Microdistrict, Irkutsk, 664049

tin11@mail.ruИркутская государственная медицинская академия последипломного образования – филиал Российской медицинской академии непрерывного профессионального образованияРоссияIrkutsk State Medical Academy of Postgraduate Education – branch of Russian Medical Academy of Continuing Professional EducationRussian FederationИркутская государственная областная детская клиническая больницаРоссияIrkutsk State Regional Children’s Clinical HospitalRussian Federation202522062025091823Copyright © Буйнова С.Н., Шинкарева В.М., Трофименко И.Н., 20252025Буйнова С.Н., Шинкарева В.М., Трофименко И.Н.Buynova S.N., Shinkareva V.M., Trofimenko I.N.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/9189

Бронхиальная астма является одним из самых частых хронических заболеваний у детей. Тяжелая астма определяется Европейским респираторным обществом и Американским торакальным обществом как астма, которая требует лечения высокими дозами комбинированной терапии ингаляционными кортикостероидами в сочетании с длительно действующими бронхолитиками и/или применения системных кортикостероидов или остается неконтролируемой, несмотря на лечение. В структуре степени тяжести тяжелая астма занимает около 5%, но она приводит к максимальному снижению качества жизни, является причиной инвалидности, а также требует значительных затрат ресурсов здравоохранения. Поэтому подбор терапии при тяжелой бронхиальной астме остается важной задачей. Внедрение в практику препаратов моноклональных антител позволяет улучшить контроль тяжелой бронхиальной астмы у детей на 5-й ступени терапии. Первым биологическим препаратом для лечения тяжелой астмы был омализумаб, и за двадцать лет применения показана его эффективность в отношении контроля симптомов, снижения частоты обострений, улучшения функции легких. Нами была проведена оценка эффективности биологической терапии. Терапия омализумабом привела к снижению частоты симптомов, количества обострений, общего IgE и улучшению функции легких по данным спирографии. Тяжелые реакции на препарат не отмечались. В статье приведен клинический пример длительного применения омализумаба у пациента с тяжелой бронхиальной астмой, что позволило достичь контроля над заболеванием, улучшить качество жизни и снизить объем базисной терапии, при этом нежелательных реакций на препарат зафиксировано не было.

Bronchial asthma is one of the most common chronic diseases in children. Severe asthma is defined by the European Respiratory Society and American Thoracic Society as asthma that requires treatment with high-dose combination therapy of inhaled corticosteroids in combination with long-acting bronchodilators and/or with the use of systemic corticosteroids, or remains uncontrolled despite treatment. In the structure of severity, severe asthma occupies about 5%, but it leads to a maximum decrease in quality of life, causes disability, and also requires significant expenditure of health care resources. Therefore, selection of therapy for severe bronchial asthma remains an important task. The introduction of monoclonal antibody drugs into practice makes it possible to improve the control of severe bronchial asthma in children at the 5th stage of therapy. The first biological drug to treat severe asthma was Omalizumab, and over twenty years of its use has been shown to be effective in controlling symptoms, reducing the frequency of exacerbations, and improving lung function. Our study assessed the effectiveness of biological therapy. Treatment with omalizumab led to in a reduction in the frequency of symptoms, number of exacerbations, total IgE, and improvement of lung function as assessed by spirography. No severe reactions to the drug were observed. The article presents a clinical example of long-term use of omalizumab in a patient with severe bronchial asthma, which made it possible to achieve control over the disease, improve quality of life and reduce the volume of basic therapy, while no adverse reactions to the drug were recorded.

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