rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2016-346-351rsp-2231Research ArticleОБЗОРREVIEWПерспективы применения ингибиторов интерлейкина 17 - нового класса препаратов для таргетной терапии псориатического артритаPROSPECTS FOR USING INTERLEUKIN-17 INHIBITORS, A NEW CLASS OF DRUGS FOR TARGETED THERAPY OF PSORIATIC ARTHRITISКоротаеваТ. В.KorotaevaT. V.

115522 Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

tatianakorotaeva@gmail.comФГБНУ Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation201620072016543346351Copyright © Коротаева Т.В., 20162016Коротаева Т.В.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://rsp.mediar-press.net/rsp/article/view/2231

Парадигма терапии псориатического артрита (ПсА) претерпела в последние годы существенные изменения вследствие разработки и внедрения в клиническую практику высокоэффективных таргетных лекарственных средств на основе моноклональных антител – ингибиторов различных цитокинов. Выполнен анализ данных литературы о возможностях применения ингибиторов интерлейкина 17 (ИЛ17) как перспективного направления терапии ПсА. Показано, что опосредованный ИЛ17 сигнальный путь играет важную роль как в хро- низации синовиального воспаления, так и в возникновении и развитии костных эрозий, костных пролифераций и энтезитов при этом заболевании. Сочетание высокой эффективности и приемлемой безопасности ингибиторов ИЛ17 и ИЛ23 позволило предположить возможность эффективного их использования в качестве средств первой линии для лечения псориаза и ПсА или в качестве терапии второй линии при неэффективности или непереносимости ингибиторов фактора некроза опухоли α. Отмечено, что активная разработка трех новых препаратов, направленных на подавление ИЛ17, только подтверждает ключевую роль этого цитокина в развитии псориатической болезни.

Приведены данные клинических исследований, подтверждающих высокую эффективность секукинумаба в отношении ключевых клинических проявлений ПсА. Отмечено, что важнейшим преимуществом препарата является отсутствие иммуногенности. Указано, что в последней редакции Рекомендаций EULAR (2015) предложено включить данный класс препаратов в алгоритм лечения больных ПсА.

The paradigm of therapy for psoriatic arthritis (PsA) has recently undergone considerable changes due to development and clinical introduction of highly effective targeted drugs based on monoclonal antibodies – inhibitors of different cytokines. The data available in the literature on the possibilities of using interleukin 17 (IL-17) inhibitors as a promising PsA therapy were analyzed. The IL-17-mediated signaling pathway was shown to play an important role in both the chronization of synovial inflammation and in the occurrence and development of bone erosions, bone proliferation, and enthesitis in this disease. The combination of the high efficiency and acceptable safety of IL-17 and IL-23 inhibitors could suggest that they might be used as first-line agents for the treatment of PsA or as second-line therapy if tumor necrosis factor-α inhibitors were ineffective or intolerable. The active design of three novel drugs aimed at suppressing IL-17 was noted to only confirm the key role of this cytokine in developing psoriatic disease.

The paper gives the data of clinical trials supporting the high efficacy of secukinumab against the key clinical manifestations of PsA. The most important advantage of the drug is the lack of immunogenicity. It is pointed out that the latest edition of the EULAR Guidelines (2015) proposes to include this class of drugs in an algorithm for the treatment of PsA patients.

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