Abstract
In patients with immune-mеdiated (autoimmune) rheumatic diseases (IMIRD), there are a number of factors (advanced age, uncontrolled inflammation, initially irreversible damage to internal organs, comorbid pathology, genetic and other factors) that can potentially lead to an increase in “sensitivity” to SARS-CoV -2 (severe acute respiratory syndrome coronavirus-2) and concomitant viral and bacterial infections, an increase in the risk of a severe course of COVID-19 (coronavirus disease 2019), a decrease in the effectiveness of therapy for both IMIRDs and COVID-19. An important area of pharmacotherapy for IMIRDs and other autoimmune diseases is associated with the use of anti-B-cell drugs, primarily rituximab (RTX), which is a chimeric (mouse/human) monoclonal antibody (mAb) to the CD20 antigen of B cells. At present, in Russia, the RTM biosimilar, acellbia (BIOCAD), is widely used, which is not inferior to RTX in terms of efficiency and safety. The problems of anti-B-cell therapy during the COVID-19 pandemic in relation to the risk of infection, severe course and insufficient effectiveness of vaccination against SARSCoV- 2 are considered. According to the recommendations of the Association of Rheumatologists of Russia, a more rigorous assessment of indications for induction and maintenance therapy of RTX therapy and harmonization of the timing of drug administration and vaccination is required.
Highlights
Рассмотрены проблемы анти-В-клеточной терапии в период пандемии COVID-19 в отношении риска инфиуниверситет имени цирования, тяжелого течения и недостаточной эффективности вакцинации против SARS-CoV-2
In patients with immune-mеdiated rheumatic diseases (IMIRD), there are a number of factors that can potentially lead to an increase in “sensitivity” to SARS-CoV -2 and concomitant viral and bacterial infections, an increase in the risk of a severe course of COVID-19, a decrease in the effectiveness of therapy for both immune-mеdiated (autoimmune) rheumatic diseases (IMIRD) and COVID-19
An important area of pharmacotherapy for IMIRDs and other autoimmune diseases is associated with the use of anti-B-cell drugs, primarily rituximab (RTX), which is a chimeric monoclonal antibody to the CD20 antigen of B cells
Summary
Примечание: ПТМ – посттрансляционно модифицированный; АНЦА – антинейтрофильные цитоплазматические антитела; ПР-3 – протеиназа-3; МПО – миелопероксидаза; ДСГ – десмоглеин; АЦХ – ацетилхолин; МСК – мышечно-специфическая киназа; РТСГ – рецептор тиреоид-стимулирующего гормона; БМКП – базальная мембрана клубочков почек. Примечание: АНЦА-СВ – системные васкулиты, связанные с синтезом антинейтрофильных цитоплазматических антител; ГИБП – генно-инженерные биологические препараты; РФ – ревматоидный фактор; ФНО-α – фактор некроза опухоли α; РТМ – ритуксимаб; ЦФ – циклофосфамид; НЛР – нежелательная лекарственная реакция; АЗА – азатиоприн; МТ – метотрексат; МФМ – микофенолата мофетил; ГХ – гидроксихлорохин; ГК – глюкокортикоиды; ЦНС – центральная нервная система; БЛМ – белимумаб; СКВ – системная красная волчанка; АФС – антифосфолипидный синдром; КриоВ – криоглобулинемический васкулит; ИЗЛ – интерстициальные заболевания легких; ПРЕД – преднизолон; п/о – перорально; ЦсА – циклоспорин А; MMT – Manual Muscle Testing; CST – Core Set Measures антител и снижением риска тяжелого течения COVID-19 после вакцинации против SARS-CoV-2 [53, 54]. Хотя по данным метаанализов контролируемых исследований связи между развитием инфекций и применением РТМ у пациентов с ИВРЗ не отмечено [64,65,66], материалы длительных наблюдательных исследований свидетельствуют о более высокой частоте инфекционных
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
