Валеология: Здоровье, Болезнь, Выздоровление. 2021; : 183-189
ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ УСТЕКИНИМУМАБА В ЛЕЧЕНИИ ПСОРИАТИЧЕСКОГО АРТРИТА
Аннотация
Для лечения псориатического артрита используются препараты генной инженерии. По результатам клинических исследований, доказана высокая эффективность препарата устекинимумаба в лечении заболеваний суставов.
Цель. Оценка эффетивности устекинимумаба в лечении псориатического артрита.
Материал и методы исследования. Был проведен анализ эффективности применения устекинимумаба у трех больных с псориатическим артритом по клинико-лабораторным данным. Данные исследования описаны на фоне шестимесячного наблюдения за пациентами.
Результаты и обсуждение. Группу наблюдения составили трое больных с псориатическим артритом с тяжелым течением. Двое пациентов имели выраженные структурные и функциональные нарушения суставов. В начале исследования индекс PASI составил 8 ± 0,43, СОЭ 63 ± 0,45, СРБ 29 ± 0,58, индекс DAS28 5,3 ± 0,35. На фоне терапии устекинимумабом в течение полугода были отмечены значительное клиническое улучшение у пациентов, снижение всех изучаемых показателей активности воспалительного процесса. Согласно рекомендаций EULAR, отмечено, что целью лечения ПсА является достижение ремиссии или минимальной активности заболевания (Treat to Target), которое позволяет замедлить или предупредить прогрессирование структурных нарушений суставов.
Выводы. Устекинимумаб способствовал через полгода применения снижению показателя PASI на 75 %, показателя СОЭ на 40 %, уменьшению СРБ на 25 %, значительно снижение активности показателей Пса. На фоне очищения кожи, снижения выраженности боли в суставах и позвоночнике улучшилось общее психоэмоциональное состояние пациентов.
Список литературы
1. Коротаева Т. В. Псориатический артрит: классификация, клиническая картина, диагностика, лечение / Т. В. Коротаева // Научно-практическая ревматология. – 2014. – 52 (6): 650-9.
2. Ritchlin C. T., Colbert R. A., Gladman D. D. Psoriatic Arthritis. N Engl J Med 2017; 376 (10): 957-70.
3. Круглова Л. С. Блокатор ИЛ-17 – новые горизонты эффективности и безопасности в лечении псориаза / Л. С. Круглова, С. В. Моисеев // Клин. фармакол. тер. – 2017. – 26 (2): 5-12.
4. Parisi R., Rutter M. K., Lunt M., et al. Psoriasis and the risk of major cardiovascular events: cohort study using the clinical practice research datalink. J Invest Dermatol 2015; 135: 2189–97.
5. Shiba M., Kato T., Funasako M., et al. Association between psoriasis vulgaris and coronary heart disease in a hospital-based population in Japan. PLoS One 2016;11: e0149316.
6. Коротаева Т. В. Иммунопатогенетические механизмы действия устекинумаба – нового лекарственного средства для лечения псориатического артрита и псориаза / Т. В. Коротаева, Е. Ю. Логинова // Современная ревматология. – 2015. – 9 (2): 51–6.
7. Kimball A. B., Papp K. A., Wasfi Y., et al. Long-term efficacy of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years in the PHOENIX 1 study. J Eur Acad Dermatol Venereol 2013; 27: 1535–45.
8. Langley R. G., Lebwohl M., Krueger G. G., et al. Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-tosevere psoriasis: results from the PHOENIX 2 study through 5 years of follow-up. Br J Dermatol 2015; 172 (5): 1371-83.
9. Tsai T. F., Ho V., Song M., et al. The safety of ustekinumab treatment in patients with moderate-to-severe psoriasis and latent tuberculosis infection. Br J Dermatol 2012; 167 (5): 1145-52.
10. Sbidian E., Giboin C., Bachelez H., et al. Factors associated with the choice of the first biologic in psoriasis: real-life analysis from the Psobioteq cohort. J Eur Acad Dermatol Venereol. 2017 Jun 13. doi: 10.1111/jdv.14406. [Epub ahead of print].
11. Menter A., Papp K. A., Gooderham M., et al. Drug survival of biologic therapy in a large, disease-base registry of patients with psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR). J Eur Acad Dermatol Venereol 2016; 30 (7): 1148-58.
12. Eder L., Haddad A., Rosen C. F., et al. The incidence and risk factors for psoriatic arthritis in patients with psoriasis: a prospective cohort study. Arthritis Rheumatol 2016; 68: 915-23.
13. Gossec L., Smolen J. S., Ramiro S., et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis 2016; 75: 499–510.
14. Coates L. C., Kavanaugh A., Mease P. J., et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis: treatment recommendations for psoriatic arthritis 2015. Arthritis Rheumatol 2016; 68: 1060–71.
15. McInnes I. B., Kavanaugh A., Gottlieb A. B., et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double blind, placebo-controlled PSUMMIT 1 trial. Lancet. 2013; 382: 780–9.
16. Ritchlin C., Rahman P., Kavanaugh A., et al. Efficacy and safety of the anti-IL12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological antitumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double blind, placebo-controlled, randomised PSUMMIT 2 trial. Ann Rheum Dis. 2014; 73: 990–9.
17. Kavanaugh A., Ritchlin C., Rahman P., et al. Ustekinumab, an anti-IL-12/23 p40 monoclonal antibody, inhibits radiographic progression in patients with active psoriatic arthritis: results of an integrated analysis of radiographic data from the phase 3, multicentre, randomised, double-blind, placebo-controlled PSUMMIT-1 and PSUMMIT-2 trials. Ann Rheum Dis 2014; 73: 1000–6.
Valeology: Health - Illnes - recovery. 2021; : 183-189
THE EFFICIENCY OF USING USTEKINUMAB IN THE TREATMENT OF PSORIATIC ARTHRITIS
Abstract
Genetic engineering drugs are used to treat psoriatic arthritis. According to the results of clinical studies, the high effectiveness of the drug ustekinimumab in the treatment of joint diseases has been proven.
Objective: to Assess efficient to ustekinumab in the treatment of psoriatic arthritis.
Material and methods: an analysis was conducted of the effectiveness of ustekinumab in three patients with psoriatic arthritis according to the clinical and laboratory data. These studies are described against the background of a six-month follow-up of patients.
Results and discussion: the observation group consisted of three patients with severe psoriatic arthritis. Two patients had pronounced structural and functional disorders of the joints. At the beginning of the study, the PASI index was 8 ± 0.43, ESR 63 ± 0.45, CRP 29 ± 0.58, and DAS28 index 5.3 ± 0.35. The therapy ustekinumab for six months saw significant clinical improvement in patients, the reduction of all studied indicators of inflammatory activity. According to the EULAR recommendations, it is noted that the goal of psa treatment is to achieve remission or minimal disease activity (Treat to Target), which allows you to slow down or prevent the progression of structural disorders of the joints.
Conclusions: Ustekinimumab contributed to a decrease in PASI by 75 %, ESR by 40 %, a decrease in CRP by 25 %, and a significant decrease in the activity of Psa indicators after six months of use. Against the background of cleansing the skin, reducing the severity of pain in the joints and spine, the general psychoemotional state of patients improved.
References
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2. Ritchlin C. T., Colbert R. A., Gladman D. D. Psoriatic Arthritis. N Engl J Med 2017; 376 (10): 957-70.
3. Kruglova L. S. Blokator IL-17 – novye gorizonty effektivnosti i bezopasnosti v lechenii psoriaza / L. S. Kruglova, S. V. Moiseev // Klin. farmakol. ter. – 2017. – 26 (2): 5-12.
4. Parisi R., Rutter M. K., Lunt M., et al. Psoriasis and the risk of major cardiovascular events: cohort study using the clinical practice research datalink. J Invest Dermatol 2015; 135: 2189–97.
5. Shiba M., Kato T., Funasako M., et al. Association between psoriasis vulgaris and coronary heart disease in a hospital-based population in Japan. PLoS One 2016;11: e0149316.
6. Korotaeva T. V. Immunopatogeneticheskie mekhanizmy deĭstviya ustekinumaba – novogo lekarstvennogo sredstva dlya lecheniya psoriaticheskogo artrita i psoriaza / T. V. Korotaeva, E. Yu. Loginova // Sovremennaya revmatologiya. – 2015. – 9 (2): 51–6.
7. Kimball A. B., Papp K. A., Wasfi Y., et al. Long-term efficacy of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years in the PHOENIX 1 study. J Eur Acad Dermatol Venereol 2013; 27: 1535–45.
8. Langley R. G., Lebwohl M., Krueger G. G., et al. Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-tosevere psoriasis: results from the PHOENIX 2 study through 5 years of follow-up. Br J Dermatol 2015; 172 (5): 1371-83.
9. Tsai T. F., Ho V., Song M., et al. The safety of ustekinumab treatment in patients with moderate-to-severe psoriasis and latent tuberculosis infection. Br J Dermatol 2012; 167 (5): 1145-52.
10. Sbidian E., Giboin C., Bachelez H., et al. Factors associated with the choice of the first biologic in psoriasis: real-life analysis from the Psobioteq cohort. J Eur Acad Dermatol Venereol. 2017 Jun 13. doi: 10.1111/jdv.14406. [Epub ahead of print].
11. Menter A., Papp K. A., Gooderham M., et al. Drug survival of biologic therapy in a large, disease-base registry of patients with psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR). J Eur Acad Dermatol Venereol 2016; 30 (7): 1148-58.
12. Eder L., Haddad A., Rosen C. F., et al. The incidence and risk factors for psoriatic arthritis in patients with psoriasis: a prospective cohort study. Arthritis Rheumatol 2016; 68: 915-23.
13. Gossec L., Smolen J. S., Ramiro S., et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis 2016; 75: 499–510.
14. Coates L. C., Kavanaugh A., Mease P. J., et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis: treatment recommendations for psoriatic arthritis 2015. Arthritis Rheumatol 2016; 68: 1060–71.
15. McInnes I. B., Kavanaugh A., Gottlieb A. B., et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double blind, placebo-controlled PSUMMIT 1 trial. Lancet. 2013; 382: 780–9.
16. Ritchlin C., Rahman P., Kavanaugh A., et al. Efficacy and safety of the anti-IL12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological antitumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double blind, placebo-controlled, randomised PSUMMIT 2 trial. Ann Rheum Dis. 2014; 73: 990–9.
17. Kavanaugh A., Ritchlin C., Rahman P., et al. Ustekinumab, an anti-IL-12/23 p40 monoclonal antibody, inhibits radiographic progression in patients with active psoriatic arthritis: results of an integrated analysis of radiographic data from the phase 3, multicentre, randomised, double-blind, placebo-controlled PSUMMIT-1 and PSUMMIT-2 trials. Ann Rheum Dis 2014; 73: 1000–6.
