Системная красная волчанка в практике терапевта


DOI: https://dx.doi.org/10.18565/therapy.2024.1.118-125

Е.А. Асеева, С.К. Соловьев, А.М. Лила

1) ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой», г. Москва; 2) ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, г. Москва
Аннотация. Цель статьи – представить рекомендации по ведению пациентов с системной красной волчанкой (СКВ) в реальной клинической практике. Освещены современные методы оценки активности СКВ, характер течения, физикальные и лабораторные методы диагностики, основные группы лекарственных средств, применяемых в терапии этого заболевания. Материал предназначен для ревматологов и терапевтов общей практики.

Литература


1. Российские клинические рекомендации. Ревматология. Под ред. академика РАН Е.Л. Насонова. М.: ГЭОТАР-Медиа. 2017; 464 с. (Russian clinical guidelines. Rheumatology. Ed. by academician of RAS Nasonov E.L. Moscow: GEOTAR-Media. 2017; 464 pp. (In Russ.)). ISBN: 978-5-9704-4261-6.


2. Lahita R.G. The immunoendocrinology of systemic lupus erythematosus. Clin Immunol. 2016; 172: 98–100. https://doi.org/10.1016/j.clim.2016.08.014. PMID: 27546447.


3. Dai C., Deng Y., Quinlan A. et al. Genetics of systemic lupus erythematosus: Immune responses and end organ resistance to damage. Curr Opin Immunol. 2014; 31: 87–96. https://doi.org/10.1016/j.coi.2014.10.004. PMID: 25458999. PMCID: PMC4274270.


4. Cervera R., Khamashta M.A., Hughes G.R. The Euro-lupus project: Epidemiology of systemic lupus erythematosus in Europe. Lupus. 2009; 18(10): 869–74. https://doi.org/10.1177/0961203309106831. PMID: 19671784.


5. Hochberg M.C. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997; 40(9): 1725. https://doi.org/10.1002/art.1780400928. PMID: 9324032.


6. Petri M., Orbai A.M., Alarcon G.S. et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012; 64(8): 2677–86. https://doi.org/10.1002/art.34473. PMID: 22553077. PMCID: PMC3409311.


7. Aringer M., Costenbader K., Daikh D. et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019; 78(9): 1151–59. https://doi.org/10.1136/annrheumdis-2018-214819. PMID: 31383717.


8. Насонов Е.Л. Коронавирусная болезнь 2019 (COVID-19) и аутоиммунитет. Научно-практическая ревматология. 2021; 59(1): 5–30. (Nasonov E.L. Coronavirus disease 2019 (COVID-19) and autoimmunity. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2021; 59(1): 5–30 (In Russ.)). https://doi.org/10.47360/1995-4484-2021-5-30. EDN: YGDNUK.


9. Gladman D.D., Ibanez D., Urowitz M.B. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002; 29(2): 288–91. PMID: 11838846.


10. Насонова В.А. Системная красная волчанка. М.: Медицина. 1972; 248 с. (Nasonova V.A. Systemic lupus erythematosus. Moscow: Medicine. 1972; 248 pp. (In Russ.)).


11. Barr S.G., Zonana-Nacach A., Magder L.S., Petri M. Patterns of disease activity in systemic lupus erythematosus. Arthritis Rheum. 1999; 42(12): 2682–88. https://doi.org/10.1002/1529-0131(199912)42:12<2682::AID-ANR26>3.0.CO;2-6. PMID: 10616018.


12. Gladman D.D., Ginzler E., Goldsmith C. et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index for systemic lupus erythematosus. Arthritis Rheum. 1996; 39(3): 363–69. https://doi.org/10.1002/art.1780390303. PMID: 8607884.


13. Tunnicliffe D.J., Singh-Grewal D., Kim S. et al. Diagnosis, Monitoring, and Treatment of Systemic Lupus Erythematosus: A Systematic Review of Clinical Practice Guidelines. Arthritis Care Res (Hoboken). 2015 Oct; 67(10): 1440–52. https://doi.org/10.1002/acr.22591.


14. Weening J.J., D’Agati V.D., Schwartz M.M. et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int. 2004; 65: 521–30. https://doi.org/10.1111/j.1523-1755.2004.00443.x.


15. Wilhelmus S., Alpers C.E., Cook H.T. et al. The revisited classification of GN in SLE at 10 years: Time to re-evaluate histopathologic lesions. J Am Soc Nephrol. 2015; 26(12): 2938–46. https://doi.org/10.1681/ASN.2015040384. PMID: 26152271. PMCID: PMC4657848.


16. van Vollenhoven R.F., Mosca M, Bertsias G. et al. Treat-to-target in systemic lupus erythematosus: Recommendations from an international task force. Ann Rheum Dis. 2014; 73(6): 958–67. https://doi.org/10.1136/annrheumdis-2013-205139. PMID: 24739325.


17. Miyakis S., Lockshin M.D., Atsumi T. et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006; 4(2): 295–306. https://doi.org/10.1111/j.1538-7836.2006.01753.x. PMID: 16420554.


18. Mosca M., Tani C., Aringer M. et al. European League Against Rheumatism recommendations for monitoring patients with systemic lupus erythematosus in clinical practice and in observational studies. Ann Rheum Dis. 2010; 69(7): 1269–74. https://doi.org/10.1136/ard.2009.117200. PMID: 19892750. PMCID: PMC2952401.


19. Hahn B.H., McMahon M.A., Wilkinson A. et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res. 2012; 64(6): 797–808. https://doi.org/10.1002/acr.21664. PMID: 22556106. PMCID: PMC3437757.


20. Bertsias G.K., Tektonidou M., Amoura Z. et al. Joint European League Against Rheumatism and European Renal Association – European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012; 71(11): 1771–82. https://doi.org/10.1136/annrheumdis-2012-201940. PMID: 22851469. PMCID: PMC3465859.


21. Pamfil C., Fanouriakis A., Damian L. et al. EULAR recommendations for neuropsychiatric systemic lupus erythematosus vs usual care: Results from two European centres. Rheumatology (Oxford). 2015; 54(7): 1270–78. https://doi.org/10.1093/rheumatology/keu482. PMID: 25638807.


22. Wilhelmus S., Bajema I.M., Bertsias G.K. et al. Lupus nephritis management guidelines compared. Nephrol Dial Transplant. 2016; 31(6): 904–13. https://doi.org/10.1093/ndt/gfv102. PMID: 25920920.


23. Hahn B.H., McMahon M.A., Wilkinson A. et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012; 64(6): 797–808. https://doi.org/10.1002/acr.21664. PMID: 22556106. PMCID: PMC3437757.


24. Fanouriakis A., Kostopoulou M., Andersen J. et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024; 83(1): 15–29. https://doi.org/10.1136/ard-2023-224762. PMID: 37827694.


25. Barile-Fabris L., Hernandez-Cabrera M.F., Barragan-Garfias J.A. Vasculitis in systemic lupus erythematosus. Curr Rheumatol Rep. 2014; 16(9): 440. https://doi.org/10.1007/s11926-014-0440-9. PMID: 25023725.


26. Wallace D.J., Navarra S., Petri M.A. et al. Safety profile of belimumab: Pooled data from placebo-controlled phase 2 and 3 studies in patients with systemic lupus erythematosus. Lupus. 2013; 22(2): 144–54. https://doi.org/10.1177/0961203312469259. PMID: 23213069.


27. Ginzler E.M., Wallace D.J., Merrill J.T. et al. Disease control and safety of belimumab plus standard therapy over 7 years in patients with systemic lupus erythematosus. J Rheumatol. 2014; 41(2): 300–9. https://doi.org/10.3899/jrheum.121368. PMID: 24187095.


28. Mok C.C. Current role of rituximab in systemic lupus erythematosus. Int J Rheum Dis. 2015; 18(2): 154–63. https://doi.org/10.1111/1756-185X.12463. PMID: 25522652.


29. Насонов Е.Л., Авдеева А.С. Иммуновоспалительные ревматические заболевания, связанные с интерфероном типа I: новые данные. Научно-практическая ревматология. 2019; 57(4): 452–461. (Nasonov E.L., Avdeeva A.S. Immunoinflammatory rheumatic diseases associated with type I interferon: New evidence. Nauchcno-prakticheskaya revmatologia = Rheumatology Science and Practice. 2019; 57(4): 452–461 (In Russ.)). https://doi.org/10.14412/1995-4484-2019-452-461. EDN: CXHYDZ.


30. Deeks E.D. Anifrolumab: First approval. Drugs. 2021; 81(15): 1795–802. https://doi.org/10.1007/s40265-021-01604-z. PMID: 34554438.


31. Gensous N., Lazaro E., Blanco P., Richez C. Anifrolumab: First biologic approved in the EU not restricted to patients with a high degree of disease activity for the treatment of moderate to severe systemic lupus erythematosus. Expert Rev Clin Immunol. 2024; 20(1): 21–30. https://doi.org/10.1080/1744666X.2023.2268284. PMID: 37800604.


32. Решетняк Т.М., Асеева Е.А., Шумилова А.А. с соавт. Портрет пациента с системной красной волчанкой для назначения ингибитора интерферона типа I анифролумаба. Современная ревматология. 2023; 17(6): 14–21. (Reshetnyak T.M., Aseeva E.A., Shumilova A.A. et al. Portrait of a patient with systemic lupus erythematosus for the prescription of the type I interferon inhibitor anifrolumab. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2023; 17(6): 14–21 (In Russ.)). https://doi.org/10.14412/1996-7012-2023-6-14-21. EDN: HPWDHK.


33. Fanouriakis A., Kostopoulou M., Andersen J. et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024; 83(1): 15–29. https://doi.org/10.1136/ard-2023-224762. PMID: 37827694.


34. Anutrakulchai S., Panaput T., Wongchinsri J. et al. A multicentre, randomised controlled study of enteric-coated mycophenolate sodium for the treatment of relapsed or resistant proliferative lupus nephritis: An Asian experience. Lupus Sci Med. 2016; 3(1): e000120. https://doi.org/10.1136/lupus-2015-000120. PMID: 26835147. PMCID: PMC4716419.


35. Choi C.B., Won S., Bae S.C. Outcomes of multitarget therapy using mycophenolate mofetil and tacrolimus for refractory or relapsing lupus nephritis. Lupus. 2018; 27(6): 1007–11. https://doi.org/10.1177/0961203318758505. PMID: 29448881.


36. Mok C.C., To C.H., Yu K.L., Ho L.Y. Combined low-dose mycophenolate mofetil and tacrolimus for lupus nephritis with suboptimal response to standard therapy: A 12-month prospective study. Lupus. 2013; 22(11): 1135–41. https://doi.org/10.1177/0961203313502864. PMID: 23995863.


37. Kasitanon N., Boripatkosol P., Louthrenoo W. Response to combination of mycophenolate mofetil, cyclosporin A and corticosteroid treatment in lupus nephritis patients with persistent proteinuria. Int J Rheum Dis. 2018; 21(1): 200–7. https://doi.org/10.1111/1756-185X.13152. PMID: 28901731.


38. Zhang J., Zhao Z., Hu X. Effect of rituximab on serum levels of anti-C1q and antineutrophil cytoplasmic autoantibodies in refractory severe lupus nephritis. Cell Biochem Biophys 2015; 72(1): 197–201. https://doi.org/10.1007/s12013-014-0437-z. PMID: 25490907.


39. Contis A., Vanquaethem H., Truchetet M.E. et al. Analysis of the effectiveness and safety of rituximab in patients with refractory lupus nephritis: A chart review. Clin Rheumatol. 2016; 35(2): 517–22. https://doi.org/10.1007/s10067-015-3166-9. PMID: 26762196.


40. Rovin B.H., Solomons N., Pendergraft W.F. 3rd et al.; AURA-LV Study Group. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis. Kidney Int. 2019; 95(1): 219–31. https://doi.org/10.1016/j.kint.2018.08.025. PMID: 30420324.


41. Schwartz N., Stock A.D., Putterman C. Neuropsychiatric lupus: New mechanistic insights and future treatment directions. Nat Rev Rheumatol. 2019; 15(3): 137–52. https://doi.org/10.1038/s41584-018-0156-8. PMID: 30659245. PMCID: PMC8023338.


42. Kronbichler A., Brezina B., Quintana L.F., Jayne D.R. Efficacy of plasma exchange and immunoadsorption in systemic lupus erythematosus and antiphospholipid syndrome: A systematic review. Autoimmun Rev. 2016; 15(1): 38–49. https://doi.org/10.1016/j.autrev.2015.08.010. PMID: 26318215.


43. Tsai P.S., Chen Y., Chen S.Y. et al. Plasmapheresis for a patient with catatonia and systemic lupus erythematosus: A case report and literature review. J Clin Med. 2022; 11(22): 6670. https://doi.org/10.3390/jcm11226670. PMID: 36431144. PMCID: PMC9692717.


44. Hegde A., Dorji T., Asturkar V. et al. Cases of catastrophic anti-phospholipid syndrome in systemic lupus erythematosus: An experience. SAGE Open Med Case Rep. 2022; 10: 2050313X221085099. https://doi.org/10.1177/2050313X221085099. PMID: 35308057. PMCID: PMC8928371.


Об авторах / Для корреспонденции


Елена Александровна Асеева, д. м. н., ведущий научный сотрудник лаборатории системной красной волчанки ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой». Адрес: 115522, г. Москва, Каширское шоссе, д. 34а.
E-mail: eaasseeva@mail.ru
ORCID: https://orcid.org/0000-0002-1663-7810
Сергей Константинович Соловьев, д. м. н., профессор, научный консультант ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой». Адрес: 115522, г. Москва, Каширское шоссе, д. 34а.
E-mail: sksoloviev@mail.ru
Александр Михайлович Лила, д. м. н., профессор, член-корреспондент РАН, директор ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», заведующий кафедрой ревматологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, заслуженный врач РФ. Адрес: 115522, г. Москва, Каширское шоссе, д. 34а.
E-mail: amlila@mail.ru
ORCID: https://orcid.org/0000-0002-6068-3080


Похожие статьи


Бионика Медиа