Affiliation:
1. Central State Medical Academy of the Administrative Department of the President of Russia
2. Tula Regional Clinical Dermatovenerological Dispensary; Tula State University
Abstract
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.