Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press30810.36691/RJA308ArticlesСтатьиReview ArticleAlgorithm of biophenotyping and choice of medication for targeted therapy of severe uncontrolled asthma with eosinophilic type of airways inflammationАлгоритм биофенотипирования и выбор таргетной терапии тяжелой неконтролируемой бронхиальной астмы с эозинофильным типом воспаления двіхательнвіх путейIlinaN IИльинаН ИNenashevaN MНенашеваНаталья Михайловна1444031@gmail.comAvdeevS NАвдеевС НAisanovZ RАйсановЗ РArkhipovV VАрхиповВ ВVizelA AВизельА АEmelyanovA VЕмельяновА ВKnyazheskayaN PКняжескаяН ПKurbachevaO MКурбачёваО МLeshchenkoI VЛещенкоИ ВOsipovaG LОсиповаГ ЛStyrtE AСтыртЕ АTitovaO NТитоваО НFassakhovR SФассаховР СFedosenkoS VФедосенкоС ВNational research center «Institute of Immunology» Federal medical-biological agencyФГБУ «ГНЦ Институт иммунологии» ФМБА РоссииRussian Medical Academy for Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииNational research center «Institute of Pulmonology» Federal medical-biological agencyФГБУ «Научно-исследовательский институт пульмонологии» ФМБА РоссииKazan state medical universityФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РоссииNorth-Western State Medical University named after I.I. MechnikovФГБОУ ВО «Северо-западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииThe Pirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаUral State Medical UniversityФГБОУ ВО «Уральский государственный медицинский университет» Минздрава РоссииThe 1st Saint Petersburg Pavlov state medical university, Scientific research institute of pulmonologyНИИ пульмонологии ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииThe Kazan Federal UniversityФГАОУ ВО «Казанский (Приволжский) Федеральный университет»«Teva» LLCОбщество с ограниченной ответственностью «Тева»15062017143VOL 14, NO3 (2017)ТОМ 14, №3 (2017)51810032020Copyright ©; 2017, Pharmarus Print MediaCopyright ©; 2017, Фармарус Принт Медиа2017Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/308

The article is based on the resolution of the Expert Council, including experts from Russian Association of Allergists and Clinical Immunologists (RAACI) and Russian Respiratory Society (RRS) dated November 20, 2016, and the review of clinical studies results and publications on the biomarker-based diagnosis and biological treatment of severe uncontrolled asthma. The aim of this work is to develop a phenotype-oriented algorithm of diagnostics and treatment of severe asthma, supported by the biomarker testing for subsequent selection of appropriate immunobiological treatment. The article constitutes the summary of results of clinical studies and expert opinions on the treatment of asthma in patients who do not achieve disease control with standard treatment regimens including high doses of inhaled corticosteroids in the combination with long-acting beta-agonists, tiotropium, and medications from other pharmacological groups according to Russian Respiratory Society (2016) and GINA (2016-2017) guidelines. The article summarizes the results of international randomized clinical studies performed to assess safety and efficacy of new class of biological treatments, monoclonal antibodies acting against major cytokines that are responsible for inflammation, in patients with severe asthma, including a new anti-IL-5 antibody, reslizumab (Cinqaero).

Статья основана на резолюции экспертного совета в составе экспертов Российской Ассоциации Аллергологов и Клинических Иммунологов (РААКИ) и Российского респираторного общества (РРО) от 20.11.2016 г. и дополнена обзором результатов клинических исследований и научных публикаций по проблеме биомаркерной диагностики и биологической терапии тяжелой плохо контролируемой астмы. Цель работы. Разработка фенотип-ориентированного алгоритма диагностики и лечения тяжелой астмы, основанного на характеристике биомаркеров для последующего целевого подбора иммунобиологического препарата. Статья представляет собой квинтэссенцию результатов исследований и мнений экспертов относительно лечения астмы, плохо контролируемой применением стандартных схем базисной терапии, включающих высокие дозы ингаляционных глюкокортикостероидов в комбинации с пролонгированными агонистами β2-адренорецепторов, тиотропия бромидом, другими группами препаратов в соответствии с рекомендациями Российского респираторного общества (2016) и GINA (2016-2017). В работе обобщены результаты международных рандомизированных клинических исследований, посвященных изучению эффективности и безопасности применения у больных тяжелой бронхиальной астмой (БА) нового класса биологических препаратов моноклональных антител против основных цитокинов, участвующих в формировании воспаления при БА, включая анти-IL-5 препарат реслизумаб (Синкейро).

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