APPLICATION OF MONOCLONAL ANTIBODIES IN THE TREATMENT OF AUTOIMMUNE RHEUMATOLOGICAL DISEASES: MODERN APPROACHES AND PROSPECTS

Monoclonal antibodies (mAbs) have revolutionized the treatment of rheumatic diseases, shifting the paradigm from non-specific immunosuppression to targeted therapy. This review systematizes clinical data on the efficacy and safety of mAbs approved for a wide range of pathologies, including inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis), systemic connective tissue diseases (systemic lupus erythematosus), ANCA-associated vasculitis, and autoinflammatory syndromes. The results of key clinical trials demonstrating the ability of mAbs to induce and maintain remission are analyzed. Special attention is paid to safety issues, particularly the risk of infections and strategies for its minimization, as well as the problem of immunogenicity and the development of anti-drug antibodies (ADAs). The role of concomitant methotrexate therapy in reducing immunogenicity and the clinical significance of therapeutic drug monitoring (TDM) for personalizing treatment are discussed. Pharmacoeconomic aspects are considered, including the impact of biosimilars on the cost and accessibility of therapy. Finally, promising future directions, such as bispecific antibodies and the use of artificial intelligence for dose optimization, are highlighted.