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Современная ревматология

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Иммунопатогенетические механизмы действия устекинумаба – нового лекарственного средства для лечения псориатического артрита и псориаза

https://doi.org/10.14412/1996-7012-2015-2-51-56

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Аннотация

Представлен анализ данных литературы о механизмах действия устекинумаба (УСТ) – нового препарата для лечения активного псориатического артрита (ПсА) и псориаза. УСТ – препарат человеческих моноклональных антител (мАТ) класса IgG1κ. Описан механизм действия препарата, показано, что УСТ эффективно нейтрализует опосредованные интерлейкином (ИЛ) 12 и 23 реакции в организме человека, но не влияет на иммунный ответ, опосредованный другими цитокинами или клеточной активностью. Рассмотрены результаты клинических исследований УСТ, посвященных лечению псориаза и ПсА, в частности PSUMMIT-1 и 2, в которые было включено 615 больных активным ПсА. Отмечена возрастающая клиническая эффективность длительного лечения УСТ: к 52-й неделе терапии у всех больных ответ по ACR20 составил 58%, по ACR50 – 34,2%, по ACR70 – 19,6%, а PASI75 – 69%. Приведены данные о том, что терапия УСТ вызывает замедление рентгенологического прогрессирования в суставах у пациентов с активным ПсА. Представлены сравнительные результаты динамики индекса массы тела (ИМТ) у больных псориазом при использовании УСТ, при этом применение препарата способствовало существенно меньшему увеличению ИМТ по сравнению с другим препаратом на основе мАТ – инфликсимабом, что актуально для пациентов с ПсА, у которых ожирение снижает клиниче-
ский эффект антицитокиновой терапии. Сделан вывод, что результаты применения УСТ подтверждают возможность успешной таргетной терапии препаратами на основе мАТ, которые эффективно уменьшают выраженность клинических проявлений псориаза и ПсА, предположительно путем локальных изменений экспрессии цитокинов в коже или синовии, однако необходимы дальнейшие фундаментальные и клинические исследования этого класса лекарственных средств, направленных на блокирование биологических эффектов определенных цитокинов.

Об авторах

Т. В. Коротаева
ФГБНУ НИИР им. В.А. Насоновой, Москва, Россия 115522, Москва, Каширское шоссе, 34А
Россия


Е. Ю. Логинова
ФГБНУ НИИР им. В.А. Насоновой, Москва, Россия 115522, Москва, Каширское шоссе, 34А
Россия


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Для цитирования:


Коротаева Т.В., Логинова Е.Ю. Иммунопатогенетические механизмы действия устекинумаба – нового лекарственного средства для лечения псориатического артрита и псориаза. Современная ревматология. 2015;9(2):51-56. https://doi.org/10.14412/1996-7012-2015-2-51-56

For citation:


Korotaeva T.V., Loginova E.Y. Immunopathogenetic mechanisms of action of ustekinumab, a new drug for the treatment of psoriatic arthritis and psoriasis. Modern Rheumatology Journal. 2015;9(2):51-56. (In Russ.) https://doi.org/10.14412/1996-7012-2015-2-51-56

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)