mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2018-1-41-46mrj-807Research ArticleОБЗОРЫREVIEWSМесто ингибитора фосфодиэстеразы 4 -го типа в стратегии лечения псориатического артритаThe place of a phosphodiesterase 4 inhibitor in the treatment strategy for psoriatic arthritisМазуровВ. И.MazurovV. I.

191015, Санкт-Петербург, ул. Кирочная, 41

41, Kirochnaya St., Saint Petersburg 191015

maz.nwgmu@yandex.ruТрофимовЕ. А.TrofimovE. A.

191015, Санкт-Петербург, ул. Кирочная, 41

41, Kirochnaya St., Saint Petersburg 191015

ГайдуковаИ. З.GaydukovaI. Z.

191015, Санкт-Петербург, ул. Кирочная, 41

41, Kirochnaya St., Saint Petersburg 191015

ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РоссииРоссияI.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaRussian Federation2018020420181214146Copyright © Мазуров В.И., Трофимов Е.А., Гайдукова И.З., 20182018Мазуров В.И., Трофимов Е.А., Гайдукова И.З.Mazurov V.I., Trofimov E.A., Gaydukova I.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/807

Псориатический артрит (ПсА) – хроническое воспалительное заболевание суставов, позвоночника и энтезисов, ассоциированное с псориазом. Патологический процесс  локализуется преимущественно в тканях опорно-двигательного аппарата и приводит к  развитию эрозивного артрита, внутрисуставного остеолиза. ПсА возникает у 5–7% больных  среднетяжелым псориазом. Несмотря на успехи в лечении псориаза и ПсА базисными  противовоспалительными препаратами (БПВП) и генно-инженерными биологическими препаратами (ГИБП), до конца не решены проблемы, связанные с иммуногенностью,  наличием инфекционных осложнений, вторичной неэффективностью. Эти факторы  послужили причиной поиска новых таргетных синтетических препаратов (блокаторы  сигнальных путей). К данной группе препаратов относится апремиласт, ингибитор  фосфодиэстеразы 4. Полученные к настоящему времени данные контролируемых  исследований свидетельствуют о том, что препарат эффективен и безопасен при лечении  псориаза и ПсА. Перспективы применения апремиласта при ПсА связаны с возможностью использования его у пациентов с неэффективностью БПВП или ГИБП, способностью  поддержания длительной (более 3 лет) ремиссии, уменьшения проявлений энтезита и дактилита.

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints, spine, and entheses, which is associated with psoriasis. The pathological process is localized mainly in the tissues of the  locomotor system and leads to the development of erosive arthritis  and intra-articular osteolysis. PsA occurs in 5–7% of patients with  moderate psoriasis. Despite advances in the treatment of psoriasis  and PsA with diseasemodifying antirheumatic drugs (DMARDs) and  biological agents (BAs), the problems associated with  immunogenicity, infectious complications, and secondary inefficiency  have not been fully solved. These factors have motivated the search  for novel targeted synthetic drugs (signaling pathway inhibitors).  This group of drugs includes apremilast, a phosphodiesterase 4  inhibitor. Recent data of controlled studies suggest that the drug is effective and safe in treating psoriasis and PsA. Prospects for the use of apremilast in PsA are associated with the possibility to use the drug in patients because of the inefficacy of DMARDs or BAs and  with the ability to maintain long-term (more than 3-year) remission  and to reduce the manifestations of enthesitis and dactylitis.

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