1 research outputs found
Π’Π°ΡΠ³Π΅ΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΡΠΎΡΠΈΠ°Π·Π°: ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΈΠ³Π½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΡΠΈ ΠΠ-23 β Π΄Π°Π½Π½ΡΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈ ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠΈ
The article presents the results of clinical studies of the efficacy and safety of the use of a new drug of genetically engineered biological therapy guselkumab. Guselkumab is the first representative of the interleukin-23 (IL-23) inhibitor class and has a number of advantages over existing therapy.
According to direct comparative randomized clinical trials, guselkumab is superior in the short-term and, most importantly, in the long-term to most genetically engineered biologic drugs, including TNF- inhibitors, secukinumab and ustekinumab.
In phase 3 studies (VOYAGE 1 and VOYAGE 2), the ECLIPSE study shows that guselkumab can achieve complete (PASI 100) and almost complete (PASI 90) skin cleansing by 16 weeks from the start of therapy in 37.4 and 73.3% of patients, respectively, with a subsequent increase in the proportion of patients with clean and almost clean skin by 24 weeks to 44.4 and 80.2%, respectively, and maintaining the achieved performance indicators for 4 years at the level of 51.7 and 84.0% respectively.
One of the potential advantages of IL-23 inhibitors is also the long-term maintenance of the achieved effect after treatment cessation. Guselkumab therapy is characterized by a favorable safety profile comparable to ustekinumab. During the follow-up period of patients in the course of randomized controlled trials of phase 3, data were obtained on the high safety of the drug and the absence of significant risks for serious infections, cardiovascular events, malignancies or suicidal tendencies. The drug is effective for insufficient response to adalimumab and ustekinumab.
The article presents 3 clinical cases of guselkumab use in patients with severe, including "problematic" psoriasis, comorbid pathology, with inefficiency or intolerance to systemic therapy, with secondary inefficiency of adalimumab. All patients managed to achieve a PASI of 90/100. No adverse events were observed.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π½ΠΎΠ²ΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΠΎΠΉ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π³ΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π±Π°. ΠΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π± ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠ΅ΡΠ²ΡΠΌ ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΠ΅Π»Π΅ΠΌ ΠΊΠ»Π°ΡΡΠ° ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠΎΠ² ΠΠ-23 ΠΈ ΠΈΠΌΠ΅Π΅Ρ ΡΡΠ΄ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ² ΠΏΠ΅ΡΠ΅Π΄ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠ΅ΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ. ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΏΡΡΠΌΡΡ
ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π³ΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π± ΠΏΡΠ΅Π²ΠΎΡΡ
ΠΎΠ΄ΠΈΡ ΠΏΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π² ΠΊΡΠ°ΡΠΊΠΎΡΡΠΎΡΠ½ΠΎΠΉ ΠΈ, ΡΡΠΎ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π²Π°ΠΆΠ½ΠΎ, Π² Π΄ΠΎΠ»Π³ΠΎΡΡΠΎΡΠ½ΠΎΠΉ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π΅ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ ΠΠΠΠ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ Π€ΠΠ-, ΡΠ΅ΠΊΡΠΊΠΈΠ½ΡΠΌΠ°Π±, ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π±. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΡΠ°Π·Ρ 3 (VOYAGE 1 ΠΈ VOYAGE 2), ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ECLIPSE ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Π³ΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π± ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΡΡΠΈΡΡ ΠΏΠΎΠ»Π½ΠΎΠ³ΠΎ (PASI 100) ΠΈ ΠΏΠΎΡΡΠΈ ΠΏΠΎΠ»Π½ΠΎΠ³ΠΎ (PASI 90) ΠΎΡΠΈΡΠ΅Π½ΠΈΡ ΠΊΠΎΠΆΠΈ ΡΠΆΠ΅ ΠΊ 16-ΠΉ Π½Π΅Π΄Π΅Π»Π΅ ΠΎΡ Π½Π°ΡΠ°Π»Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ 37,4 ΠΈ 73,3% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ, Ρ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠΈΠΌ Π½Π°ΡΠ°ΡΡΠ°Π½ΠΈΠ΅ΠΌ Π΄ΠΎΠ»ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΈΡΡΠΎΠΉ ΠΈ ΠΏΠΎΡΡΠΈ ΡΠΈΡΡΠΎΠΉ ΠΊΠΎΠΆΠ΅ΠΉ ΠΊ 24-ΠΉ Π½Π΅Π΄Π΅Π»Π΅ Π΄ΠΎ 44,4 ΠΈ 80,2% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ ΠΈ ΡΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ΠΌ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 4 Π»Π΅Ρ Π½Π° ΡΡΠΎΠ²Π½Π΅ Ρ 51,7 ΠΈ 84,0% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ² ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠΎΠ² ΠΠ-23 ΡΠ°ΠΊΠΆΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΊΡΠ° ΠΏΠΎΡΠ»Π΅ ΠΏΡΠ΅ΠΊΡΠ°ΡΠ΅Π½ΠΈΡ Π»Π΅ΡΠ΅Π½ΠΈΡ. Π’Π΅ΡΠ°ΠΏΠΈΡ Π³ΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π±ΠΎΠΌ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΌ ΠΏΡΠΎΡΠΈΠ»Π΅ΠΌ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ, ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡΠΌ Ρ ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π±ΠΎΠΌ. Π ΠΏΠ΅ΡΠΈΠΎΠ΄ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Ρ
ΠΎΠ΄Π΅ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ 3-ΠΉ ΡΠ°Π·Ρ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π²ΡΡΠΎΠΊΠΎΠΉ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠΈ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΡΠΈΡΠΊΠΎΠ² Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΡΠ΅ΡΡΠ΅Π·Π½ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ, ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
ΡΠΎΠ±ΡΡΠΈΠΉ, Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈΠ»ΠΈ ΡΡΠΈΡΠΈΠ΄Π°Π»ΡΠ½ΡΡ
Π½Π°ΠΊΠ»ΠΎΠ½Π½ΠΎΡΡΠ΅ΠΉ. ΠΡΠ΅ΠΏΠ°ΡΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΈ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΌ ΠΎΡΠ²Π΅ΡΠ΅ Π½Π° Π°Π΄Π°Π»ΠΈΠΌΡΠΌΠ°Π± ΠΈ ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π±.
Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ 3 ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ»ΡΡΠ°Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π³ΡΡΠ΅Π»ΡΠΊΡΠΌΠ°Π±Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΡΠΌ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ½ΡΠΌ ΠΏΡΠΎΡΠΈΠ°Π·ΠΎΠΌ, ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ, Ρ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ Π»ΠΈΠ±ΠΎ Π½Π΅ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠΈΠΌΠΎΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ, Ρ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ Π°Π΄Π°Π»ΠΈΠΌΡΠΌΠ°Π±Π°. Π£ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ΄Π°Π»ΠΎΡΡ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΡ PASI 90/100. ΠΠ΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΠ²Π»Π΅Π½ΠΈΡ Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ