Перспективы применения ингибиторов интерлейкина 17 - нового класса препаратов для таргетной терапии псориатического артрита

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.

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