medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-6-216-225medsovet-6833Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYСовременный взгляд на лечение псориатической болезни. Опыт применения генно-инженерной биологической терапии у пациентов с распространенным псориазом среднетяжелого и тяжелого теченияA modern view on the treatment of psoriatic disease. Experience in using genetically engineered biological therapy in patients with extensive moderate to severe psoriasishttps://orcid.org/0000-0002-5885-4872СвечниковаЕ. В.SvechnikovaE. V.

д.м.н., профессор кафедры, заведующая отделением дерматовенерологии и косметологии, 

119002, Москва, пер. Сивцев Вражек, д. 26/28

Dr. Sci. (Med.), Professor, Chief Department of Dermatovenerology and Cosmetology, 

26/28, Sivtsev Vrazhek Lane, Moscow, 119002

elene-elene@bk.ruhttps://orcid.org/0000-0001-5694-2847ЖуфинаС. Е.ZhufinaS. E.

врач-дерматовенеролог отделения дерматовенерологии и косметологии, 

119002, Москва, пер. Сивцев Вражек, д. 26/28

Dermatovenerologist, Department of Dermatovenerology and Cosmetology, 

26/28, Sivtsev Vrazhek Lane, Moscow, 119002

svetlanagufina@gmail.comПоликлиника №1 Управления делами Президента Российской ФедерацииРоссияPolyclinic No. 1 of the Administrative Department of the Russian FederationRussian Federation20222704202206216225Copyright © Свечникова Е.В., Жуфина С.Е., 20222022Свечникова Е.В., Жуфина С.Е.Svechnikova E.V., Zhufina S.E.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/6833

В статье представлен современный взгляд на патогенез псориаза, рассмотрен подход к ведению пациентов с распространенным псориазом среднетяжелого и  тяжелого течения, сформулированы основные особенности лечения генноинженерными биологическими препаратами разных групп: ингибиторами ФНО-альфа, IL-17, IL-23. Также проанализированы данные литературы об основных особенностях, показаниях, противопоказаниях и побочных эффектах, связанных с применением генно-инженерных препаратов. Изучен опыт лечения, описанный в отечественных и зарубежных научных изданиях. Были рассмотрены подходы к лечению пациентов со среднетяжелым и тяжелым течением псориаза в сочетании с сопутствующими коморбидными патологиями, также были оценены особенности лечения генно-инженерными биологическими препаратами из разных групп. Кроме того, в работе приведены результаты собственных наблюдений, полученных при лечении пациентов с распространенным псориазом и сопутствующей коморбидной патологией такими биологическими препаратами, как секукинумаб (10 пациентов), нетакимаб (5 пациентов), гуселькумаб (7 пациентов). Приведены схемы обследования пациентов, режимы дозирования каждого препарата, оценена эффективность, переносимость и проанализированы полученные осложнения во время лечения каждым препаратом, оценены скорость и устойчивость терапевтического эффекта каждого из них. С появлением новых данных о патогенезе и лечении псориаза появились дополнительные возможности для пациентов получать своевременную помощь, длительно поддерживать заболевание в стадии ремиссии и повышать качество жизни, независимо от  выраженности и  стадии патологического процесса, а  также от  особенностей анамнеза и  наличия коморбидных состояний. 

The article presents a modern view on the pathogenesis of psoriasis, considers an approach to management of patients with extensive moderate to severe psoriasis, sets out the key features of treatment with genetically engineered biological drugs of different groups: TNF-alpha, IL-17, IL-23 inhibitors. Literature data on the key features, indications, contraindications, and side effects associated with the use of genetically engineered drugs have also been analysed. The experience of using therapies described in domestic and foreign research publications was examined. Approaches to the treatment of patients with moderate to severe psoriasis combined with concomitant comorbid pathologies were discussed, and the features of treatment with genetically engineered biological drugs of different groups were also evaluated. In addition, the publication contains the results of our own observations obtained in the treatment of patients with extensive psoriasis and concomitant comorbid pathology using such biological drugs as secukinumab (10 patients), netakimab (5 patients), guselcumab (7 patients). The schemes of patient investigation, dosage regimens for each drug are given, their efficacy and tolerability are evaluated, and complications acquired during treatment with each drug are analysed, the speed and stability of the therapeutic effect provided by each of them are evaluated. In connection with the emergence of new data on the pathogenesis and treatment of psoriasis, patients have increasing opportunities to receive timely care, maintain disease remission for a long time and improve the quality of life regardless of the severity and stage of the pathological process, as well as of the history and presence of comorbid conditions. 

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