pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2018-28-3-341-358pulmo-1005Research ArticleОБЗОРЫREVIEWРаспространенность, заболеваемость, фенотипы и другие характеристики тяжелой бронхиальной астмы в Российской ФедерацииPrevalence, morbidity, phenotypes and other characteristics of severe bronchial asthma in Russian FederationАвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич – доктор медицинских наук, член-корреспондент Российской академии наук, профессор, заведующий кафедрой пульмонологии Федерального государственного бюджетного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации, руководитель клинического отдела Федерального государственного бюджетного учреждения «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства

119991, Москва, ул. Трубецкая, 8, стр. 2, 115682, Москва, Ореховый бульвар, 28

Sergey N. Avdeev, Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology, I.M.Sechenov First Federal Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Head of Clinical Division, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia

ul. Trubetskaya 8, build. 2, Moscow, 119991, Orekhovyy bul'var 28, Moscow, 115682

 

serg_avdeev@list.ruНенашеваН. М.NenashevaN. M.

Ненашева Наталья Михайловна – доктор медицинских наук, профессор кафедры клинической аллергологии

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Natal'ya M. Nenasheva, Doctor of Medicine, Professor, Department of Clinical Allergology

ul. Barrikadnaya 2/1, Moscow, 123995

 

1444031@gmail.comЖуденковК. В.ZhudenkovK. V.

Жуденков Кирилл Владимирович – кандидат биологических наук, старший научный сотрудник

119530, Москва, Очаковское шоссе, 28, стр. 2, пом. I, комн. 39

Kirill V. Zhudenkov, Candidate of Biology, Senior Researcher

Ochakovskoye shosse 28, build. 2, office 2, room 1, Moscow, 119530

 

kirill.zhudenkov@msdecisions.ruПетраковскаяВ. А.PetrakovskayaV. A.

Петраковская Вера Александровна – кандидат медицинских наук, медицинский менеджер

125284 Москва, ул. Беговая, 3, стр. 1

Vera A. Petrakovskaya, Candidate of Medicine, Medical Manager

ul. Begovaya 3, build. 1, Moscow, 125284

 

Vera.Petrakovskaia@astrazeneca.comИзюмоваГ. В.IzyumovaG. V.

Изюмова Галина Валентиновна – руководитель терапевтического направления

125284 Москва, ул. Беговая, 3, стр. 1

 

Galina V. Izyumova, Head of Therapeutic Field

ul. Begovaya 3, build. 1, Moscow, 125284

 

izyumova.galina@astrazeneca.comФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентстваРоссияI.M.Sechenov First Federal Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Federal Pulmonology Research Institute, Federal Medical and Biological Agency of RussiaRussian FederationФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian State Academy of Continued Medical Education, Healthcare Ministry of RussiaRussian FederationОбщество с ограниченной ответственностью «Эм энд Эс десижанс»РоссияM&S Decisions LLCRussian FederationОбщество с ограниченной ответственностью «АстраЗенека Фармасьютикалз»РоссияAstraZeneca Pharmaceuticals LLCRussian Federation201830072018283341358Copyright © Авдеев С.Н., Ненашева Н.М., Жуденков К.В., Петраковская В.А., Изюмова Г.В., 20182018Авдеев С.Н., Ненашева Н.М., Жуденков К.В., Петраковская В.А., Изюмова Г.В.Avdeev S.N., Nenasheva N.M., Zhudenkov K.V., Petrakovskaya V.A., Izyumova G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1005

В обзоре приведены данные по распространенности, фенотипам, эндотипам и уровню контроля над тяжелой бронхиальной астмой (ТБА). ТБА – широкораспространенное гетерогенное заболевание, от которого страдают 5–20 % больных бронхиальной астмой (БА). Заболеваемость ТБА в России, по данным фармакоэпидемиологических исследований, значительно превышает данные официальной статистики, поэтому необходимо ведение национального регистра больных ТБА. Традиционный подход к терапии ТБА не всегда эффективен ввиду возможного неконтролируемого течения заболевания и сохранения признаков эозинофильного воспаления дыхательных путей. Выделение фенотипов / эндотипов целесообразно для разработки индивидуального подхода к терапии больных ТБА, что позволяет добиться лучшего контроля над заболеванием и минимизировать риски развития обострений, фиксированной обструкции дыхательных путей и нежелательных побочных эффектов лечения. В статье представлены основные изменения в Глобальной инициативе по БА (Global Initiative for Asthma, 2018), касающиеся терапии ТБА, а также подчеркнуто, что применение препаратов моноклональных интерлейкинов (IL)-5 и антител к иммуноглобулину (Ig) E может способствовать достижению успеха при лечении пациентов с неконтролируемой ТБА. В настоящее время в России зарегистрированы 2 иммунобиологических препарата, относящихся к группе фенотип-обусловленных методов терапии ТБА: омализумаб (анти-IgE-терапия) и реслизумаб (анти-IL-5-терапия).

 

The article provides a review on prevalence, phenotypes, endotypes, and the control of severe bronchial asthma. Severe asthma is a widespread, heterogeneous disease that affects 5 – 20% of patients with bronchial asthma. Prevalence of severe asthma in Russia significantly exceeds the official statistics data, therefore it is necessary to maintain a national register of patients with severe asthma. The conventional therapy for severe asthma is not always effective due to the uncontrolled course of the disease and eosinophilic airway inflammation. The identification of asthma phenotype/endotype is reasonable to develop a personalized approach to treatment. This approach allows achievement better control of the disease and minimization the risk of asthma exacerbations, fixed airway obstruction, and adverse effects of the pharmacological therapy. The main changes in the Global Strategy for Asthma Management and Prevention (GINA, 2018) concerning severe asthma therapy are highlighted in this article. It is also emphasized that the use of monoclonal IL-5 and IgE-antibodies could contribute to successful treatment of patients with uncontrolled severe asthma. Currently, two immunobiological drugs have been registered in Russia, omalizumab (anti-IgE antibody) and reslizumab (anti-IL-5 antibody).

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