奈达单抗对银屑病患者的疗效和长达 1 年的病程:实施基因工程生物疗法早期处方战略

L. S. Kruglova, N. Pereverzina, N. Rudneva
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The study included a total of 16 patients aged 18–35 years with a period of manifestation of skin psoriasis <1 year, who received netakimab at a dosage of 120 mg subcutaneously at 0, 1, 2 weeks and then 120 mg every month for 52 weeks.Results. By week 4, 68.75% (n=11) of patients achieved PASI 75, 37.5 % (n=6) PASI90 and 18.75% (n=3) PASI100. By week 8, delta PASI75 was observed in 87.5% (n=14) of patients, 68.75% (n=11) – PASI90 and 50% (n=8) – PASI100. By week 24, 100% (n=16) of patients achieved PASI75,81.25% (n=13) – PASI90 and 68.75% (n=11) – PASI100. By week 52, PASI75 delta was observed in 100% (n=16) patients, 100% (n=16) had PASI90 and 87.5% (n=14) had PASI100.Conclusions. Patients with a shorter duration of the disease (up to 1 year) during netakimab therapy achieve PASI75, PASI90, PASI100 in a shorter time (comparison with clinical trial data). 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摘要

目前,在实际临床实践中,越来越多的人一致认为,及早服用具有生物活性的药物,不仅可以防止皮肤病理过程的进展,还可以防止银屑病关节炎的发生,对合并病症和全身炎症相关并发症也有好处。考虑到银屑病发病的各个阶段,早期治疗可以改变病程,不仅可以预防严重病症和残疾的发生,还可以阻止银屑病的发展。在这方面,IL-17A 阻断剂的处方是合理的。该研究共纳入了16名年龄在18-35岁、皮肤银屑病表现期小于1年的患者,他们分别在0、1、2周时皮下注射120毫克的奈达吉单抗,然后每月注射120毫克,共52周。第4周时,68.75%(11人)的患者PASI达到75,37.5%(6人)的患者PASI达到90,18.75%(3人)的患者PASI达到100。到第 8 周,87.5%(14 人)的患者达到 PASI75,68.75%(11 人)达到 PASI90,50%(8 人)达到 PASI100。到第 24 周,100%(16 人)的患者达到 PASI75,81.25%(13 人)达到 PASI90,68.75%(11 人)达到 PASI100。到第 52 周,100%(16 人)的患者达到 PASI75 delta,100%(16 人)的患者达到 PASI90,87.5%(14 人)的患者达到 PASI100。结论:在奈达单抗治疗期间,病程较短(1年以内)的患者能在较短时间内达到PASI75、PASI90和PASI100(与临床试验数据比较)。如果存在银屑病病程迁延的因素(病程进展迅速、发病时病程广泛、局部治疗效果不佳、病程持续进展、PsA 的危险因素、PsA 的亚临床病程),应考虑尽早采用基因工程生物疗法(奈达单抗)作为最合适的策略。
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Efficacy of netakimab in patients with psoriasis and disease duration up to 1 year: implementation of a strategy for early prescription of genetic engineering biological therapy
Currently, in actual clinical practice, there is an increasing consensus that early administration of a biologically active drug not only prevents the progression of the pathological process in the skin, but also prevents the development of psoriatic arthritis, and also has a beneficial effect on comorbid pathologies and complications associated with systemic inflammation. Early treatment can modify the course of the disease and prevent not only the development of severe forms and disability, but also stop the progression of psoriasis, taking into account all stages of pathogenesis. In this aspect, the prescription of IL-17A blockers is justified.Material and methods. The study included a total of 16 patients aged 18–35 years with a period of manifestation of skin psoriasis <1 year, who received netakimab at a dosage of 120 mg subcutaneously at 0, 1, 2 weeks and then 120 mg every month for 52 weeks.Results. By week 4, 68.75% (n=11) of patients achieved PASI 75, 37.5 % (n=6) PASI90 and 18.75% (n=3) PASI100. By week 8, delta PASI75 was observed in 87.5% (n=14) of patients, 68.75% (n=11) – PASI90 and 50% (n=8) – PASI100. By week 24, 100% (n=16) of patients achieved PASI75,81.25% (n=13) – PASI90 and 68.75% (n=11) – PASI100. By week 52, PASI75 delta was observed in 100% (n=16) patients, 100% (n=16) had PASI90 and 87.5% (n=14) had PASI100.Conclusions. Patients with a shorter duration of the disease (up to 1 year) during netakimab therapy achieve PASI75, PASI90, PASI100 in a shorter time (comparison with clinical trial data). In the presence of factors for the aggressive course of psoriasis (rapid progression of the process, widespread process upon manifestation, lack of effect from topical therapy, constantly progressive course, risk factors for PsA, subclinical course of PsA), early prescription of genetic engineering biological therapy (netakimab) should be considered as the most appropriate strategy.
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