medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-420medsovet-7942Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYЭффективность тофацитиниба при псориатическом артрите: обзор литературы и клиническое наблюдениеEfficacy of tofacitinib in psoriatic arthritis: literature review and case reporthttps://orcid.org/0000-0002-0928-3911ГридневаГ. И.GridnevaG. I.

Гриднева Галина Игоревна - кандидат медицинских наук, научный сотрудник лаборатории коморбидных инфекций и вакцинопрофилактики отдела воспалительных заболеваний суставов.

115522, Москва, Каширское шоссе, д. 34а

Galina I. Gridneva - Cand. Sci. (Med.), Researcher at the Laboratory of Comorbid Infections and Vaccination of the Department of Inflammatory Diseases of the Joints, Nasonova Research Institute of Rheumatology.

34а, Kashirskoe Shosse, Moscow, 115522

gigridneva@mail.ruhttps://orcid.org/0000-0002-1833-5357АроноваЕ. С.AronovaE. S.

Аронова Евгения Сергеевна – кандидат медицинских наук, научный сотрудник лаборатории коморбидных инфекций и вакцинопрофилактики отдела воспалительных заболеваний суставов.

115522, Москва, Каширское шоссе, д. 34а

Evgenia S. Aronova - Cand. Sci. (Med.), Researcher at the Laboratory of Comorbid Infections and Vaccination of the Department of Inflammatory Diseases of the Joints, Nasonova Research Institute of Rheumatology.

34а, Kashirskoe Shosse, Moscow, 115522

eugpozd@mail.ruНаучно-исследовательский институт ревматологии имени В.А. НасоновойРоссияNasonova Research Institute of RheumatologyRussian Federation202323112023021143150Copyright © Гриднева Г.И., Аронова Е.С., 20232023Гриднева Г.И., Аронова Е.С.Gridneva G.I., Aronova E.S.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/7942

В статье представлены результаты поиска в базах данных PubMed и Google Scholar работ (метаанализы, систематические обзоры, клинические испытания и тематические исследования), в которых проводится оценка терапии псориатического артрита (ПсА) тофацитинибом (ТОФА) – препаратом из группы ингибиторов янус-киназ (JAK-киназ); особый интерес представляли данные, опубликованные за 2020–2023 гг. Обзор содержит наиболее актуальные сведения об эффективности и безопасности ТОФА, приведено краткое описание механизма действия ТОФА с упоминанием блокируемых им сигнальных внутриклеточных путей. Изложен спектр «ключевых» клинических проявлений псориатического артрита (ПсА), при которых наиболее полно раскрывается терапевтический потенциал ТОФА: периферический артрит, псориаз, энтезит и дактилит. Рассмотрены недавно опубликованные результаты основных рандомизированных контролируемых (OPAL Broaden и OPAL Beyond), постмаркетинговых исследований, а также результаты описательных исследований и клинических наблюдений, продемонстрирована высокая эффективность ТОФА для лечения ПсА у больных, не ответивших на терапию базисными противовоспалительными препаратами (БПВП) и/или препаратами из группы ингибиторов фактора некроза опухоли (TNF ingibitors – TNFi). Изложены результаты (и их интерпретация) изучения безопасности длительного применения разных доз ТОФА – 5 мг 2 раза в сутки и 10 мг 2 раза в сутки, а также удержания («выживаемости») терапии с акцентом на нежелательные явления (НЯ) особого интереса (большие кардиологические события (major adverse cardiac events, MACE), онкологические заболевания, инфекции). Приведены результаты лечения ТОФА больных ПсА по данным общероссийского регистра больных. Особо подчеркивается выраженное положительное влияние ТОФА на параметры, которые определяются как «состояние здоровья, по мнению пациента» (patient-reported outcome – PRO): показатели усталости, самооценки, оценки пациентом своего состояния по ВАШ, оценки по HAQ-DI (Health Assessment Questionnaire), SF-36 (неспецифический опросник для оценки качества жизни пациента) и т. д. Представлено клиническое наблюдение, которое демонстрирует яркий лечебный эффект ТОФА в отношении артрита, энтезита, дактилита, клинических признаков спондилита, сакроилеита, а также кожного процесса у пациента с активным ПсА.

The article presents the results of a search in the PubMed and Google Scholar databases (meta-analyses, systematic reviews, clinical trials and case studies) evaluating the treatment of PsA with tofacitinib (TOFA). The review contains the most up-to-date information about the efficacy and safety of TOFA, a drug from the group of janus kinase inhibitors (JAKi), a brief description of the mechanism of action of TOFA is given, with mention of blocked signaling intracellular pathways. The spectrum of “key” clinical manifestations of psoriatic arthritis (PsA) is described, in which the therapeutic potential of TOFA (peripheral arthritis, psoriasis, enthesitis and dactylitis) is most fully revealed. The results of the main randomized controlled trials (OPAL Broaden and OPAL Beyond), postmarketing trials, descriptive studies and clinical observations are considered, and the high efficacy of TOFA for the treatment of PsA patients who did not respond to therapy with synthetic disease-modifying drugs and/ or Tumor Necrosis Factor inhibitors (TNFi) is demonstrated. The results (and their interpretation) of studying the safety of long-term use of different doses of TOFA – 5 mg 2 times a day and 10 mg 2 times a day and retention (“survival”) are presented therapy, with an emphasis on adverse events of special interest (“large” cardiological events (MACE), oncologics, infections). The results of treatment with tofacitinib in patients with PsA according to the All-Russian register of patients are presented. The pronounced positive effect of TOFA on the parameters that are defined as “patient-reported outcome – PRO” is particularly emphasized: indicators of fatigue, self-assessment, patient’s assessment of his condition according to VAS, assessment by HAQ-DI (Health Assessment Questionnaire), SF-36 (non-specific questionnaire for quality assessment patient’s life), etc. A clinical observation is presented that demonstrates a vivid therapeutic effect on arthritis, enteritis, dactylitis, clinical signs of spondylitis, sacroiliitis, as well as the skin process in a patient with active PsA.

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