medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-21-274-283medsovet-5993Research ArticleПрактикаPracticeХарактеристика больных псориатическим артритом, получающих лечение устекинумабом. Данные реальной клинической практикиCharacteristics of patients with psoriatic arthritis treated with ustekinumab. Evidence from real-life clinical practicehttps://orcid.org/0000-0001-5968-2403КорсаковаЮ. Л.KorsakovaYu. L.

к.м.н., старший научный сотрудник лаборатории спондилоартритов и псориатического артрита, 

115522, Москва, Каширское шоссе, д. 34a

Cand. of Sci. (Med.), Senior Researcher of the Department of Spondyloarthritis and Psoriatic Arthritis, 

34a, Kashirskoe Shosse, Moscow, 115522

yulkorsakova@bk.ruhttps://orcid.org/0000-0001-6875-4552ЛогиноваЕ. Ю.LoginovaE. Yu.

к.м.н., старший научный сотрудник лаборатории спондилоартритов и псориатического артрита,

115522, Москва, Каширское шоссе, д. 34a

Cand. of Sci. (Med.), Senior Researcher of the Department of Spondyloarthritis and Psoriatic Arthritis, 

34a, Kashirskoe Shosse, Moscow, 115522

eyloginova@mail.ruhttps://orcid.org/0000-0001-5015-7143ГубарьЕ. Е.GubarE. E.

к.м.н., старший научный сотрудник лаборатории спондилоартритов и псориатического артрита,

115522, Москва, Каширское шоссе, д. 34a

Cand. of Sci. (Med.), Senior Researcher of the Department of Spondyloarthritis and Psoriatic Arthritis, 

34a, Kashirskoe Shosse, Moscow, 115522

gubarelena@yandex.ruКоротаеваТ. В.KorotaevaT. V.

д.м.н., заведующая лабораторией спондилоартритов и псориатического артрита, 

115522, Москва, Каширское шоссе, д. 34a

Dr. of Sci. (Med.), Head of the Department of Spondyloarthritis and Psoriatic Arthritis, 

34a, Kashirskoe Shosse, Moscow, 115522

tatianakorotaeva@gmail.comНаучно-исследовательский институт ревматологии им. В.А. НасоновойРоссияNasonova Scientific Research Institute of RheumatologyRussian Federation202017012021021274283Copyright © Корсакова Ю.Л., Логинова Е.Ю., Губарь Е.Е., Коротаева Т.В., 20212021Корсакова Ю.Л., Логинова Е.Ю., Губарь Е.Е., Коротаева Т.В.Korsakova Y.L., Loginova E.Y., Gubar E.E., Korotaeva T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5993Введение

Введение. Псориатический артрит (ПсА) – хроническое иммуновоспалительное заболевание, характеризующееся вовлечением в воспалительный процесс кожи, ногтевых пластин, суставов, позвоночника и энтезисов. Ингибитор ИЛ-12/ИЛ-23 устекинумаб (УСТ) находит все более широкое применение при псориазе (Пс) и ПсА.

Цель исследования

Цель исследования. Провести анализ пациентов с ПсА, находившихся на стационарном лечении в ФГБНУ НИИР им. В.А. Насоновой, которым был назначен УСТ в течение 2018– 2020 гг. Материал и методы. УСТ был назначен 17 больным ПсА (9 женщин и 8 мужчин), средний возраст которых 46,4 ± 11,3 года. Длительность течения ПсА – 11 ± 10,5 года. Пациентам проводилось клиническое, лабораторное и инструментальное обследование, определялись BSA, индексы PASI, DAPSA, BASDAI.

Результаты

Результаты. У пациентов наблюдался преимущественно распространенный Пс (BSA 18,2 ± 15,9%). У 94,1% больных был эрозивный артрит, у 100% больных выявлен сакроилеит. Активность ПсА была высокой (DAPSA = 44,9 ± 20,9, BASDAI = 6,2 ± 1,5). У 94% больных имелись два и более сопутствующих заболевания. У 82,4% пациентов наблюдались заболевания системы кровообращения, у 29,5% – печени, у 47% – желудочно-кишечного тракта, у 17,6% – эндокринной системы, у 23,5% больных был вирусный гепатит С, у 17,6% – латентная туберкулезная инфекция, 11,2% перенесли операции на суставах. Приведенный в статье клинический пример демонстрирует хорошую переносимость УСТ у больной ПсА с рядом сопутствующих заболеваний и возможность увеличить дозу УСТ с 45 до 90 мг при неэффективности терапии.

Выводы

Выводы. УСТ характеризуется хорошим профилем безопасности, его назначение возможно больным с кардиоваскулярными заболеваниями, ожирением, различными инфекциями, включая латентный туберкулез и др. 

Introduction

Introduction. Psoriatic arthritis (PsA) is a chronic immunoinflammatory disease characterised by involvement of the skin, nail plates, joints, spine and entheses in the inflammatory process. The IL-12/IL-23 inhibitor ustekinumab (UST) is increasingly being used in psoriasis (Ps) and PsA.

Aim of the study

Aim of the study. To analyze patients with PsA who were under inpatient treatment in the V.A. Nasonova Scientific Research Institute of Rheumatology and Radiology and who were prescribed UST during the period from 2018 to 2020.

Material and methods

Material and methods. UST was administered to 17 patients with PsA (9 women and 8 men), mean age was 46.4 ± 11.3 years. Duration of PsA course was 11 ± 10.5 years. Patients underwent clinical, laboratory and instrumental examination, BSA and PASI, DAPSA and BASDAI indices were determined.

Results

Results. Patients predominantly had widespread Ps (BSA 18.2 ± 15.9%). Erosive arthritis was present in 94.1% of patients, and sacroiliitis was detected in 100% of patients. PsA activity was high (DAPSA = 44.9 ± 20.9, BASDAI = 6.2 ± 1.5).

94% of patients had two or more comorbidities. Circulatory system diseases were observed in 82.4% of patients, liver diseases in 29.5%, gastrointestinal diseases in 47%, endocrine system diseases in 17.6%, viral hepatitis C in 23.5%, latent tuberculosis infection in 17.6%, and joint surgery was performed in 11.2% of patients. The clinical example presented in the article demonstrates good tolerability of UST in a patient with PsA with a number of comorbidities and the possibility to increase the dose of UST from 45 to 90 mg in case of ineffective therapy.

Conclusions

Conclusions. The safety profile of UST is good, and it can be administered to patients with cardiovascular diseases, obesity, various infections, including latent tuberculosis, etc. 

псориазпсориатический артритустекинумабсопутствующие заболеваниякардиоваскулярные заболеванияинфекцииpsoriasispsoriatic arthritisustekinumabcomorbiditiescardiovascular diseasesinfectionsReferencesOgdie A., Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):545–568. doi: 10.1016/j.rdc.2015.07.001.Ogdie A., Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):545–568. doi: 10.1016/j.rdc.2015.07.001.McArdle A., Pennington S., Fitzgerald O. Clinical features of psoriatic arthritis: a comprehensive review of unmet clinical needs. Clin Rev Allergy Immunol. 2018;55(3):271–294. doi: 10.1007/s12016-017-8630-7.McArdle A., Pennington S., Fitzgerald O. Clinical features of psoriatic arthritis: a comprehensive review of unmet clinical needs. Clin Rev Allergy Immunol. 2018;55(3):271–294. doi: 10.1007/s12016-017-8630-7.Галушко Е.А., Насонов Е.Л. Распространенность ревматических заболеваний в России. Альманах клинической медицины. 2018;46(1):32– 39. doi: 10.18786/2072-0505-2018-46-1-32-39.Galushko E.A., Nasonov E.L. Prevalence of rheumatic diseases in Russia. Al'manakh klinicheskoy meditsiny = Almanac of Clinical Medicine. 2018;46(1):32–39. (In Russ.) doi: 10.18786/2072-0505-2018-46-1-32-39.Zeboulon N., Dougados M., Gossec L. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis. 2008;67(7):955–959. doi: 10.1136/ard.2007.075754.Zeboulon N., Dougados M., Gossec L. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis. 2008;67(7):955–959. doi: 10.1136/ard.2007.075754.Hawkes J.E., Chan T.C., Krueger J.G. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol. 2017;14(3):645–653. doi: 10.1016/j.jaci.2017.07.004.Hawkes J.E., Chan T.C., Krueger J.G. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol. 2017;14(3):645–653. doi: 10.1016/j.jaci.2017.07.004.Dowlatshahi E.A., Wakkee M., Arends L.R., Nijsten T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542–1551. doi: 10.1038/jid.2013.508.Dowlatshahi E.A., Wakkee M., Arends L.R., Nijsten T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542–1551. doi: 10.1038/jid.2013.508.de Korte J., Sprangers M.A., Mombers F.M., Bos J.D. Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc. 2004;9(2):140–147. doi: 10.1046/j.1087-0024.2003.09110.x.de Korte J., Sprangers M.A., Mombers F.M., Bos J.D. Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc. 2004;9(2):140–147. doi: 10.1046/j.1087-0024.2003.09110.x.Schaefer C.P., Cappelleri J.C., Cheng R., Cole J.C., Guenthner S., Fowler J.. et al. Health care resource use, productivity, and costs among patients with moderate to severe plaque psoriasis in the United States. J Am Acad Dermatol. 2015;73(4):585–593.e3. doi: 10.1016/j.jaad.2015.06.049.Schaefer C.P., Cappelleri J.C., Cheng R., Cole J.C., Guenthner S., Fowler J.. et al. Health care resource use, productivity, and costs among patients with moderate to severe plaque psoriasis in the United States. J Am Acad Dermatol. 2015;73(4):585–593.e3. doi: 10.1016/j.jaad.2015.06.049.Dubreuil M., Rho Y.H., Man D., Zhu Y., Zhang Y., Love T.J. et al. Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study. Rheumatology (Oxford). 2014;53(2):346–352. doi: 10.1093/rheumatology/ket343.Dubreuil M., Rho Y.H., Man D., Zhu Y., Zhang Y., Love T.J. et al. Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study. Rheumatology (Oxford). 2014;53(2):346–352. doi: 10.1093/rheumatology/ket343.Ogdie A., Grewal S.K., Noe M.H., Shin D.B., Takeshita J., Chiesa Fuxench Z. et al. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study. J Invest Dermatol. 2018;138(4):760–767. doi: 10.1016/j.jid.2017.10.024.Ogdie A., Grewal S.K., Noe M.H., Shin D.B., Takeshita J., Chiesa Fuxench Z. et al. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study. J Invest Dermatol. 2018;138(4):760–767. doi: 10.1016/j.jid.2017.10.024.Labitigan M., Bahce-Altuntas A., Kremer J.M., Reed G., Greenberg J.D., Jordan N. et al. Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(4):600–607. doi: 10.1002/acr.22185.Labitigan M., Bahce-Altuntas A., Kremer J.M., Reed G., Greenberg J.D., Jordan N. et al. Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(4):600–607. doi: 10.1002/acr.22185.Coto-Segura P., Eiris-Salvado N., Gonzalez-Lara L., Queiro-Silva R., Martinez-Camblor P., Maldonado-Seral C. et al. Psoriasis, psoriatic arthritis and type 2 diabetes mellitus: a systematic review and meta-analysis. Br J Dermatol. 2013;169(4):783–793. doi: 10.1111/bjd.12473.Coto-Segura P., Eiris-Salvado N., Gonzalez-Lara L., Queiro-Silva R., Martinez-Camblor P., Maldonado-Seral C. et al. Psoriasis, psoriatic arthritis and type 2 diabetes mellitus: a systematic review and meta-analysis. Br J Dermatol. 2013;169(4):783–793. doi: 10.1111/bjd.12473.Caso F., Del Puente A., Oliviero F., Peluso R., Girolimetto N., Bottiglieri P. et al. Metabolic syndrome in psoriatic arthritis: the interplay with cutaneous involvement. Evidences from literature and a recent cross-sectional study. Clin Rheumatol. 2018;37(3):579–586. doi: 10.1007/s10067-017-3975-0.Caso F., Del Puente A., Oliviero F., Peluso R., Girolimetto N., Bottiglieri P. et al. Metabolic syndrome in psoriatic arthritis: the interplay with cutaneous involvement. Evidences from literature and a recent cross-sectional study. Clin Rheumatol. 2018;37(3):579–586. doi: 10.1007/s10067-017-3975-0.Davidovici B.B., Sattar N., Prinz J., Puig L., Emery P., Barker J.N. et al. Psoriasis and systemic inflammatory diseases: Potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol. 2010;130(7):1785–1796. doi: 10.1038/jid.2010.103.Davidovici B.B., Sattar N., Prinz J., Puig L., Emery P., Barker J.N. et al. Psoriasis and systemic inflammatory diseases: Potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol. 2010;130(7):1785–1796. doi: 10.1038/jid.2010.103.Boehncke W.H., Boehncke S., Tobin A.M., Kirby B. The ‘psoriatic march’: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20(4):303–307. doi: 10.1111/j.1600-0625.2011.01261.x.Boehncke W.H., Boehncke S., Tobin A.M., Kirby B. The ‘psoriatic march’: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20(4):303–307. doi: 10.1111/j.1600-0625.2011.01261.x.Takeshita J., Grewal S., Langan S.M., Mehta N.N., Ogdie A., Van Voorhees A.S., Gelfand J.M. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017;76(3):393–403. doi: 10.1016/j.jaad.2016.07.065.Takeshita J., Grewal S., Langan S.M., Mehta N.N., Ogdie A., Van Voorhees A.S., Gelfand J.M. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017;76(3):393–403. doi: 10.1016/j.jaad.2016.07.065.McDonough E., Ayearst R., Eder L., Chandran V., Rosen C.F., Thavaneswaran A., Gladman D.D. Depression and anxiety in psoriatic disease: prevalence and associated factors. J Rheumatol. 2014;41(5):887–896. doi: 10.3899/jrheum.130797.McDonough E., Ayearst R., Eder L., Chandran V., Rosen C.F., Thavaneswaran A., Gladman D.D. Depression and anxiety in psoriatic disease: prevalence and associated factors. J Rheumatol. 2014;41(5):887–896. doi: 10.3899/jrheum.130797.Sumarac-Dumanovic M., Stevanovic D., Ljubic A., Jorga J., Simic M., Stamenkovic-Pejkovic D. et al. Increased activity of interleukin-23/interleukin-17 proinflammatory axis in obese women. Int J Obes (Lond.). 2009;33(1):151–156. doi: 10.1038/ijo.2008.216.Sumarac-Dumanovic M., Stevanovic D., Ljubic A., Jorga J., Simic M., Stamenkovic-Pejkovic D. et al. Increased activity of interleukin-23/interleukin-17 proinflammatory axis in obese women. Int J Obes (Lond.). 2009;33(1):151–156. doi: 10.1038/ijo.2008.216.Husni M.E. Comorbidities in psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):677–698. doi: 10.1016/j.rdc.2015.07.008.Husni M.E. Comorbidities in psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):677–698. doi: 10.1016/j.rdc.2015.07.008.Насонов Е.Л. (ред.) Ревматология: российские клинические рекомендации. М.: ГЭОТАР-Медиа; 2017. 464 с.Nasonov E.L. (ed.) Rheumatology: Russian clinical guidelines. Moscow: GEOTAR-Media; 2017. 464 p. (In Russ.)Raychaudhuri S.P., Wilken R., Sukhov A.C., Raychaudhuri S.K., Maverakis E. Management of psoriatic arthritis: Early diagnosis, monitoring of disease severity and cutting edge therapies. J Autoimmun. 2017;76:21–37. doi: 10.1016/j.jaut.2016.10.009.Raychaudhuri S.P., Wilken R., Sukhov A.C., Raychaudhuri S.K., Maverakis E. Management of psoriatic arthritis: Early diagnosis, monitoring of disease severity and cutting edge therapies. J Autoimmun. 2017;76:21–37. doi: 10.1016/j.jaut.2016.10.009.Johnsson H.J., Mcinnes I.B. Interleukin-12 and interleukin-23 inhibition in psoriatic arthritis. Clin Exp Rheumatol. 2015;33(5 Suppl. 93):S115–8. Available at: https://www.clinexprheumatol.org/abstract.asp?a=9895.Johnsson H.J., Mcinnes I.B. Interleukin-12 and interleukin-23 inhibition in psoriatic arthritis. Clin Exp Rheumatol. 2015;33(5 Suppl. 93):S115–8. Available at: https://www.clinexprheumatol.org/abstract.asp?a=9895.Wang E.A., Suzuki E., Maverakis E., Adamopoulos I.E. Targeting IL-17 in psoriatic arthritis. Eur J Rheumatol. 2017;4(4):272–277. doi: 10.5152/eurjrheum.2017.17037.Wang E.A., Suzuki E., Maverakis E., Adamopoulos I.E. Targeting IL-17 in psoriatic arthritis. Eur J Rheumatol. 2017;4(4):272–277. doi: 10.5152/eurjrheum.2017.17037.Papp K.A., Langley R.G., Lebwohl M., Krueger G.G., Szapary P., Yeilding N. et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371(9625):1675–1684. doi: 10.1016/S0140-6736(08)60726-6.Papp K.A., Langley R.G., Lebwohl M., Krueger G.G., Szapary P., Yeilding N. et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371(9625):1675–1684. doi: 10.1016/S0140-6736(08)60726-6.Tsai T.F., Ho J.C., Song M., Szapary P., Guzzo C., Shen Y.K. et al. Efficacy and safety of ustekinumab for the treatment of moderate-to-severe psoriasis: a phase III, randomized, placebo controlled trial in Taiwanese and Korean patients (PEARL). J Dermatol Sci. 2011;63(3):154–163. doi: 10.1016/j.jdermsci.2011.05.005.Tsai T.F., Ho J.C., Song M., Szapary P., Guzzo C., Shen Y.K. et al. Efficacy and safety of ustekinumab for the treatment of moderate-to-severe psoriasis: a phase III, randomized, placebo controlled trial in Taiwanese and Korean patients (PEARL). J Dermatol Sci. 2011;63(3):154–163. doi: 10.1016/j.jdermsci.2011.05.005.Ritchlin C., Rahman P., Kavanaugh A., McInnes I.B., Puig L., Li S. et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour 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(6):990–999. doi: 10.1136/annrheumdis-2013-204655.Ritchlin C., Rahman P., Kavanaugh A., McInnes I.B., Puig L., Li S. et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour 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(6):990–999. doi: 10.1136/annrheumdis-2013-204655.McInnes I.B., Kavanaugh A., Gottlieb A.B., Puig L., Rahman P., Ritchlin C. 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(9894):780–789. doi: 10.1016/S0140- 6736(13)60594-2.McInnes I.B., Kavanaugh A., Gottlieb A.B., Puig L., Rahman P., Ritchlin C. 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(9894):780–789. doi: 10.1016/S0140- 6736(13)60594-2.Gottlieb A., Menter A., Mendelsohn A., Shen Y.K., Li S., Guzzo C. et al. Ustekinumab, a human interleukin 12/23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet. 2009;373(9664):633–640. doi: 10.1016/S0140-6736(09)60140-9.Gottlieb A., Menter A., Mendelsohn A., Shen Y.K., Li S., Guzzo C. et al. Ustekinumab, a human interleukin 12/23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet. 2009;373(9664):633–640. doi: 10.1016/S0140-6736(09)60140-9.Kavanaugh A., Ritchlin C., Rahman P., Puig L., Gottlieb A.B., Li S. 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(6):1000–1006. doi: 10.1136/annrheumdis-2013-204741.Kavanaugh A., Ritchlin C., Rahman P., Puig L., Gottlieb A.B., Li S. 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(6):1000–1006. doi: 10.1136/annrheumdis-2013-204741.Lee M.P., Desai R.J., Jin Y., Brill G., Ogdie A., Kim S.C. Association of Ustekinumab vs TNF Inhibitor Therapy With Risk of Atrial Fibrillation and Cardiovascular Events in Patients With Psoriasis or Psoriatic Arthritis. JAMA Dermatol. 2019;155(6):700–707. doi: 10.1001/jamadermatol.2019.0001.Lee M.P., Desai R.J., Jin Y., Brill G., Ogdie A., Kim S.C. Association of Ustekinumab vs TNF Inhibitor Therapy With Risk of Atrial Fibrillation and Cardiovascular Events in Patients With Psoriasis or Psoriatic Arthritis. JAMA Dermatol. 2019;155(6):700–707. doi: 10.1001/jamadermatol.2019.0001.Ding T., Ledingham J., Luqmani R., Westlake S., Hyrich K., Lunt M. et al. BSR and BHPR rheumatoid arthritis guidelines safety of anti-TNF therapies. Rheumatology (Oxford). 2010;49(11):2217–2219. doi: 10.1093/rheumatology/keq249a.Ding T., Ledingham J., Luqmani R., Westlake S., Hyrich K., Lunt M. et al. BSR and BHPR rheumatoid arthritis guidelines safety of anti-TNF therapies. Rheumatology (Oxford). 2010;49(11):2217–2219. doi: 10.1093/rheumatology/keq249a.Al-Mutairi N., Nour T. The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial. Expert Opin Biol Ther. 2014;14(6):749–756. doi: 10.1517/14712598.2014.900541.Al-Mutairi N., Nour T. The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial. Expert Opin Biol Ther. 2014;14(6):749–756. doi: 10.1517/14712598.2014.900541.Renzo L.D., Saraceno R., Schipani C., Rizzo M., Bianchi A., Noce A. et al. Prospective assessment of body weight and body composition changes in patients with psoriasis receiving anti-TNF-alpha treatment. Dermatol Ther. 2011;24(4):446–451. doi: 10.1111/j.1529-8019.2011.01439.x.Renzo L.D., Saraceno R., Schipani C., Rizzo M., Bianchi A., Noce A. et al. Prospective assessment of body weight and body composition changes in patients with psoriasis receiving anti-TNF-alpha treatment. Dermatol Ther. 2011;24(4):446–451. doi: 10.1111/j.1529-8019.2011.01439.x.Galindez E., Carmona L. Is obesity in psoriatic arthritis associated with a poorer therapeutic response and more adverse effects of treatment with an anchor drug? Reumatol Clin. 2016;12(6):307–312. doi: 10.1016/j.reuma.2015.12.005.Galindez E., Carmona L. Is obesity in psoriatic arthritis associated with a poorer therapeutic response and more adverse effects of treatment with an anchor drug? Reumatol Clin. 2016;12(6):307–312. doi: 10.1016/j.reuma.2015.12.005.Iannone F., Lopalco G., Rigante D., Orlando I., Cantarini L., Lapadula G. Impact of obesity on the clinical outcome of rheumatologic patients in biotherapy. Autoimmun Rev. 2016;15(5):447–450. doi: 10.1016/j.autrev.2016.01.010.Iannone F., Lopalco G., Rigante D., Orlando I., Cantarini L., Lapadula G. Impact of obesity on the clinical outcome of rheumatologic patients in biotherapy. Autoimmun Rev. 2016;15(5):447–450. doi: 10.1016/j.autrev.2016.01.010.Iannone F., Santo L., Bucci R., Semeraro A., Carlino G., Paoletti F. et al. Drug survival and effectiveness of ustekinumab in patients with psoriatic arthritis. Real-life data from the biologic Apulian registry (BIOPURE). Clin Rheumatol. 2018;37(3):667–675. doi: 10.1007/s10067-018-3989-2.Iannone F., Santo L., Bucci R., Semeraro A., Carlino G., Paoletti F. et al. Drug survival and effectiveness of ustekinumab in patients with psoriatic arthritis. Real-life data from the biologic Apulian registry (BIOPURE). Clin Rheumatol. 2018;37(3):667–675. doi: 10.1007/s10067-018-3989-2.Gisondi P., Conti A., Galdo G., Piaserico S., De Simone C., Girolomoni G. Ustekinumab does not increase body mass index in patients with chronic plaque psoriasis: a prospective cohort study. Br J Dermatol. 2013;168(5):1124–1127. doi: 10.1111/bjd.12235.Gisondi P., Conti A., Galdo G., Piaserico S., De Simone C., Girolomoni G. Ustekinumab does not increase body mass index in patients with chronic plaque psoriasis: a prospective cohort study. Br J Dermatol. 2013;168(5):1124–1127. doi: 10.1111/bjd.12235.Xie X., Li F., Chen J.W., Wang J. Risk of tuberculosis infection in anti-TNF-α biological therapy: from bench to bedside. J Microbiol Immunol Infect. 2014;47(4):268–274. doi: 10.1016/j.jmii.2013.03.005.Xie X., Li F., Chen J.W., Wang J. Risk of tuberculosis infection in anti-TNF-α biological therapy: from bench to bedside. J Microbiol Immunol Infect. 2014;47(4):268–274. doi: 10.1016/j.jmii.2013.03.005.Новиков П.И., Моисеев С.В. Этанерцепт: безопасность при HCV и HBV инфекции и латентном туберкулезе, риск бактериальных инфекций и вакцинации (часть 2). Клиническая фармакология и терапия. 2016;25(4):85–91. Режим доступа: https://clinpharm-journal.ru/files/articles/etanertsept-bezopasnost-pri-hcv-i-hbv-infektsii-i-latentnomtuberkuleze-risk-bakterialnyh-infektsij-i-vaktsinatsiya-chast-2.pdf.Novikov P.I., Moiseev S.V. Etanercept: safety in patients with HCV- and HBV-infection and latent tuberculosis, risk of bacterial infections and vaccinations (part 2). Klinicheskaya farmakologiya i terapiya = Clin Farmacol Ther. 2016;25(4):85–91. (In Russ.) Available at: https://clinpharm-journal.ru/files/articles/etanertsept-bezopasnost-pri-hcv-i-hbv-infektsii-i-latentnom-tuberkuleze-risk-bakterialnyh-infektsij-i-vaktsinatsiya-chast-2.pdf.Minozzi S., Bonovas S., Lytras T., Pecoraro V., González-Lorenzo M., Bastiampillai A.J. et al. Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Expert Opin Drug Saf. 2016;15(Suppl. 1):11–34. doi: 10.1080/14740338.2016.1240783.Minozzi S., Bonovas S., Lytras T., Pecoraro V., González-Lorenzo M., Bastiampillai A.J. et al. Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Expert Opin Drug Saf. 2016;15(Suppl. 1):11–34. doi: 10.1080/14740338.2016.1240783.Papp K.A., Griffiths C.E., Gordon K., Lebwohl M., Szapary P.O., Wasfi Y. et al. Long-term safety of ustekinumab in patients with moderate-to-severe psoriasis: final results from 5 years of follow-up. Br J Dermatol. 2013;168(4):844–854. doi: 10.1111/bjd.12214.Papp K.A., Griffiths C.E., Gordon K., Lebwohl M., Szapary P.O., Wasfi Y. et al. Long-term safety of ustekinumab in patients with moderate-to-severe psoriasis: final results from 5 years of follow-up. Br J Dermatol. 2013;168(4):844–854. doi: 10.1111/bjd.12214.Piaserico S., Messina F., Russo F.P. Managing Psoriasis in Patients with HBV or HCV Infection: Practical Considerations. Am J Clin Dermatol. 2019;20(6):829–845. doi: 10.1007/s40257-019-00457-3.Piaserico S., Messina F., Russo F.P. Managing Psoriasis in Patients with HBV or HCV Infection: Practical Considerations. Am J Clin Dermatol. 2019;20(6):829–845. doi: 10.1007/s40257-019-00457-3.Ting S.W., Chen Y.C., Huang Y.H. Risk of Hepatitis B Reactivation in Patients with Psoriasis on Ustekinumab. Clin Drug Investig. 2018;38(9):873–880. doi: 10.1007/s40261-018-0671-z.Ting S.W., Chen Y.C., Huang Y.H. Risk of Hepatitis B Reactivation in Patients with Psoriasis on Ustekinumab. Clin Drug Investig. 2018;38(9):873–880. doi: 10.1007/s40261-018-0671-z.Czarnecka-Operacz M., Sadowska-Przytocka A. The possibilities and principles of methotrexate treatment of psoriasis – the updated knowledge. Postepy Dermatol Alergol. 2014;31(6):392–400. doi: 10.5114/pdia.2014.47121.Czarnecka-Operacz M., Sadowska-Przytocka A. The possibilities and principles of methotrexate treatment of psoriasis – the updated knowledge. Postepy Dermatol Alergol. 2014;31(6):392–400. doi: 10.5114/pdia.2014.47121.Hsu S., Papp K.A., Lebwohl M.G., Bagel J., Blauvelt A., Duffin K.C. et al. Consensus guidelines for the management of plaque psoriasis. Arch Dermatol. 2012;148(1):95–102. doi: 10.1001/archdermatol.2011.1410.Hsu S., Papp K.A., Lebwohl M.G., Bagel J., Blauvelt A., Duffin K.C. et al. Consensus guidelines for the management of plaque psoriasis. Arch Dermatol. 2012;148(1):95–102. doi: 10.1001/archdermatol.2011.1410.Menter A., Gottlieb A., Feldman S.R., Van Voorhees A.S., Leonardi C.L., Gordon K.B. et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826–850. doi: 10.1016/j.jaad.2008.02.039.Menter A., Gottlieb A., Feldman S.R., Van Voorhees A.S., Leonardi C.L., Gordon K.B. et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826–850. doi: 10.1016/j.jaad.2008.02.039.Nast A., Gisondi P., Ormerod A.D., Saiag P., Smith C., Spuls P.I. et al. European S3-Guidelines on the systemic treatment of psoriasis vulgaris – Update 2015 – Short version – EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29(12):2277–2294. doi: 10.1111/jdv.13354.Nast A., Gisondi P., Ormerod A.D., Saiag P., Smith C., Spuls P.I. et al. European S3-Guidelines on the systemic treatment of psoriasis vulgaris – Update 2015 – Short version – EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29(12):2277–2294. doi: 10.1111/jdv.13354.Conde-Taboada A., Muñoz J.P., Muñoz L.C., López-Bran E. Infliximab treatment for severe psoriasis in a patient with active hepatitis B virus infection. J Am Acad Dermatol. 2009;60(6):1077–1080. doi: 10.1016/j.jaad.2008.09.057.Conde-Taboada A., Muñoz J.P., Muñoz L.C., López-Bran E. Infliximab treatment for severe psoriasis in a patient with active hepatitis B virus infection. J Am Acad Dermatol. 2009;60(6):1077–1080. doi: 10.1016/j.jaad.2008.09.057.Cooper S., Erickson A.L., Adams E.J., Kansopon J., Weiner A.J., Chien D.Y. et al. Analysis of a successful immune response against hepatitis C virus. Immunity. 1999;10(4):439–449. doi: 10.1016/s1074-7613(00)80044-8.Cooper S., Erickson A.L., Adams E.J., Kansopon J., Weiner A.J., Chien D.Y. et al. Analysis of a successful immune response against hepatitis C virus. Immunity. 1999;10(4):439–449. doi: 10.1016/s1074-7613(00)80044-8.Lechner F., Wong D.K., Dunbar P.R., Chapman R., Chung R.T., Dohrenwend P. et al. Analysis of successful immune responses in persons infected with hepatitis C virus. J Exp Med. 2000;191(9):1499–1512. doi: 10.1084/jem.191.9.1499.Lechner F., Wong D.K., Dunbar P.R., Chapman R., Chung R.T., Dohrenwend P. et al. Analysis of successful immune responses in persons infected with hepatitis C virus. J Exp Med. 2000;191(9):1499–1512. doi: 10.1084/jem.191.9.1499.Abuchar A., Vitiello M., Kerdel F.A. Psoriasis treated with ustekinumab in a patient with hepatitis C. Int J Dermatol. 2013;52(3):381–382. doi: 10.1111/j.1365-4632.2011.04876.x.Abuchar A., Vitiello M., Kerdel F.A. Psoriasis treated with ustekinumab in a patient with hepatitis C. Int J Dermatol. 2013;52(3):381–382. doi: 10.1111/j.1365-4632.2011.04876.x.Chiu H.Y., Chen C.H., Wu M.S., Cheng Y.P., Tsai T.F. The safety profile of ustekinumab in the treatment of patients with psoriasis and concurrent hepatitis B or C. Br J Dermatol. 2013;169(6):1295–303. doi: 10.1111/bjd.12461.Chiu H.Y., Chen C.H., Wu M.S., Cheng Y.P., Tsai T.F. The safety profile of ustekinumab in the treatment of patients with psoriasis and concurrent hepatitis B or C. Br J Dermatol. 2013;169(6):1295–303. doi: 10.1111/bjd.12461.Navarro R., Vilarrasa E., Herranz P., Puig L., Bordas X., Carrascosa J.M. et al. Safety and effectiveness of ustekinumab and antitumour necrosis factor therapy in patients with psoriasis and chronic viral hepatitis B or C: a retrospective, multicentre study in a clinical setting. Br J Dermatol. 2013;168(3):609–616. doi: 10.1111/bjd.12045.Navarro R., Vilarrasa E., Herranz P., Puig L., Bordas X., Carrascosa J.M. et al. Safety and effectiveness of ustekinumab and antitumour necrosis factor therapy in patients with psoriasis and chronic viral hepatitis B or C: a retrospective, multicentre study in a clinical setting. Br J Dermatol. 2013;168(3):609–616. doi: 10.1111/bjd.12045.Fiorentino D., Ho V., Lebwohl M.G., Leite L., Hopkins L., Galindo C. et al. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry. J Am Acad Dermatol. 2017;77(5):845–854. doi: 10.1016/j.jaad.2017.07.013.Fiorentino D., Ho V., Lebwohl M.G., Leite L., Hopkins L., Galindo C. et al. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry. J Am Acad Dermatol. 2017;77(5):845–854. doi: 10.1016/j.jaad.2017.07.013.Taylor W., Gladman D., Helliwell P., Marchesoni A., Mease P., Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthr Rheum. 2006;54(8):2665–2673. doi: 10.1002/art.21972.Taylor W., Gladman D., Helliwell P., Marchesoni A., Mease P., Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthr Rheum. 2006;54(8):2665–2673. doi: 10.1002/art.21972.Horn E.J., Fox K.M., Patel V., Chiou C.F., Dann F., Lebwohl M. Association of patient-reported psoriasis severity with income and employment. J Am Acad Dermatol. 2007;57(6):963–971. doi: 10.1016/j.jaad.2007.07.023.Horn E.J., Fox K.M., Patel V., Chiou C.F., Dann F., Lebwohl M. Association of patient-reported psoriasis severity with income and employment. J Am Acad Dermatol. 2007;57(6):963–971. doi: 10.1016/j.jaad.2007.07.023.Fredriksson T., Pettersson U. Severe psoriasis – oral therapy with a new retinoid. Dermatologica. 1978;157(4):238–244. doi: 10.1159/000250839.Fredriksson T., Pettersson U. Severe psoriasis – oral therapy with a new retinoid. Dermatologica. 1978;157(4):238–244. doi: 10.1159/000250839.Schoels M.M., Aletaha D., Alasti F., Smolen J.S. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75(5):811–818. doi: 10.1136/annrheumdis-2015-207507.Schoels M.M., Aletaha D., Alasti F., Smolen J.S. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75(5):811–818. doi: 10.1136/annrheumdis-2015-207507.Garret S., Jenkinson T., Kennedy L.C., Whitelock H., Gaisford P., Calin A. A new approach to defining disease status in ankylosing spondylitis: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). J Rheumatol. 1994;21(12):2286–2291. Available at: https://pubmed.ncbi.nlm.nih.gov/7699630.Garret S., Jenkinson T., Kennedy L.C., Whitelock H., Gaisford P., Calin A. A new approach to defining disease status in ankylosing spondylitis: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). J Rheumatol. 1994;21(12):2286–2291. Available at: https://pubmed.ncbi.nlm.nih.gov/7699630.Elyoussfi S., Thomas B.J., Ciurtin C. Tailored treatment options for patients with psoriatic arthritis and psoriasis: review of established and new biologic and small molecule therapies. Rheumatol Int. 2016;36(5):603–612. doi: 10.1007/s00296-016-3436-0.Elyoussfi S., Thomas B.J., Ciurtin C. Tailored treatment options for patients with psoriatic arthritis and psoriasis: review of established and new biologic and small molecule therapies. Rheumatol Int. 2016;36(5):603–612. doi: 10.1007/s00296-016-3436-0.Jamnitski A., Symmons D., Peters M.J., Sattar N., McInnes I., Nurmohamed M.T. Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis. 2013;72(2):211–216. doi: 10.1136/annrheumdis-2011-201194.Jamnitski A., Symmons D., Peters M.J., Sattar N., McInnes I., Nurmohamed M.T. Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis. 2013;72(2):211–216. doi: 10.1136/annrheumdis-2011-201194.Ogdie A., Yu Y., Haynes K., Love T.J., Maliha S., Jiang Y. et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015;74(2):326–332. doi: 10.1136/annrheumdis-2014-205675.Ogdie A., Yu Y., Haynes K., Love T.J., Maliha S., Jiang Y. et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015;74(2):326–332. doi: 10.1136/annrheumdis-2014-205675.Kimball A.B., Guerin A., Latremouille-Viau D., Yu A.P., Gupta S., Bao Y., Mulani P. Coronary heart disease and stroke risk in patients with psoriasis. Am J Med. 2010;123(4):350–357. doi: 10.1016/j.amjmed.2009.08.022.Kimball A.B., Guerin A., Latremouille-Viau D., Yu A.P., Gupta S., Bao Y., Mulani P. Coronary heart disease and stroke risk in patients with psoriasis. Am J Med. 2010;123(4):350–357. doi: 10.1016/j.amjmed.2009.08.022.Gelfand J.M., Dommasch E.D., Shin D.B., Azfar R.S., Kurd S.K., Wang X., Troxel A.B. The risk of stroke in patients with psoriasis. J Invest Dermatol. 2009;129(10):2411–2418. doi: 10.1038/jid.2009.112.Gelfand J.M., Dommasch E.D., Shin D.B., Azfar R.S., Kurd S.K., Wang X., Troxel A.B. The risk of stroke in patients with psoriasis. J Invest Dermatol. 2009;129(10):2411–2418. doi: 10.1038/jid.2009.112.Xu T., Zhang Y.H. Association of psoriasis with stroke and myocardial infarction: meta-analysis of cohort studies. Br J Dermatol. 2012;167(6):1345–1350. doi: 10.1111/bjd.12002.Xu T., Zhang Y.H. Association of psoriasis with stroke and myocardial infarction: meta-analysis of cohort studies. Br J Dermatol. 2012;167(6):1345–1350. doi: 10.1111/bjd.12002.Frers R.A.K., Bisoendial R.J., Montoya S.F., Kerzkerg E., Castilla R., Tak P.P. et al. Psoriasis and cardiovascular risk: Immune-mediated crosstalk between metabolic, vascular and autoimmune inflammation. IJC Metab Endocr. 2015;6:43– 54. doi: 10.1016/j.ijcme.2015.01.005.Frers R.A.K., Bisoendial R.J., Montoya S.F., Kerzkerg E., Castilla R., Tak P.P. et al. Psoriasis and cardiovascular risk: Immune-mediated crosstalk between metabolic, vascular and autoimmune inflammation. IJC Metab Endocr. 2015;6:43– 54. doi: 10.1016/j.ijcme.2015.01.005.Fernández-Gutiérrez B., Perrotti P.P., Gisbert J.P., Domènech E., FernándezNebro A., Cañete J.D. et al. Cardiovascular disease in immune-mediated inflammatory diseases: A cross-sectional analysis of 6 cohorts. Medicine (Baltimore). 2017;96(26):e7308. doi: 10.1097/MD.0000000000007308.Fernández-Gutiérrez B., Perrotti P.P., Gisbert J.P., Domènech E., FernándezNebro A., Cañete J.D. et al. Cardiovascular disease in immune-mediated inflammatory diseases: A cross-sectional analysis of 6 cohorts. Medicine (Baltimore). 2017;96(26):e7308. doi: 10.1097/MD.0000000000007308.Gossec L., Smolen J.S., Ramiro S., de Wit M., Cutolo M., Dougados M. et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis. 2016;75(3):499–510. doi: 10.1136/annrheumdis-2015-208337.Gossec L., Smolen J.S., Ramiro S., de Wit M., Cutolo M., Dougados M. et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis. 2016;75(3):499–510. doi: 10.1136/annrheumdis-2015-208337.Coates L.C., Moverley A.R., McParland L., Brown S., Navarro-Coy N., O’Dwyer J.L. et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386(10012):2489–2498. doi: 10.1016/S0140-6736(15)00347-5.Coates L.C., Moverley A.R., McParland L., Brown S., Navarro-Coy N., O’Dwyer J.L. et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386(10012):2489–2498. doi: 10.1016/S0140-6736(15)00347-5.

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