Современные достижения в биологической терапии псориаза: эффективность препарата гуселькумаб в реальной клинической практике

Псориаз – хроническое иммуновоспалительное заболевание кожи, которое на сегодняшний день рассматривается как системный процесс с учетом связи со множеством коморбидных состояний. При псориазе происходит сложное взаимодействие Т-клеток и кератиноцитов. Всесторонне патогенез псориаза до конца не изучен, однако известно, что ключевым в развитии заболевания является путь ИЛ-23/Th17. С появлением генно-инженерных биологических препаратов лечение псориаза претерпело значительные перемены благодаря их высокой эффективности за счет таргетного воздействия. Гуселькумаб – первый препарат для лечения псориаза средней и тяжелой степени, который имеет направленное действие на субъединицу p19 интерлейкина (ИЛ) 23. Эффективность гуселькумаба была доказана рядом клинических исследований. К настоящему времени в литературе опубликовано небольшое количество серий случаев из реальной клинической практики, отражающих применение гуселькумаба при псориазе тяжелой степени, включая показатель выживаемости в течение длительного периода времени, а также сохранение эффективности у пациентов с сопутствующими патологиями. В статье рассматриваются результаты ключевых исследований эффективности гуселькумаба, а также приведены собственные клинические случаи успешного применения препарата. Отмечено, что гуселькумаб способен воспроизвести результаты, полученные в исследованиях, в условиях реальной клинической практики. При этом представленные случаи также вызывают интерес с учетом наличия в них сопутствующего метаболического синдрома, ожирения, которое зачастую затрудняет ответ на терапию. Данная группа пациентов обычно отличается особой торпидностью течения псориаза и определенной рефрактерностью к проводимому лечению. Таким образом, гуселькумаб отличается эффективным и безопасным профилем, помимо этого, удобством применения, а улучшение качества жизни пациентов на фоне терапии определяет его перспективным в качестве препарата первой линии среди генно-инженерных биологических препаратов для лечения псориаза.

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