Evolution of biological therapy for psoriasis: realities and prospects

Cover Page

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


INTRODUCTION: Psoriasis is a common multifactorial chronic dermatosis. Despite numerous studies, its pathogenesis is still not fully understood. Currently, great importance is given to disorders in the regulation of the immune system. Knowledge of the key links of pathogenesis, the main cytokines allow us to purposefully act on them, leading to a stop in the cascade of immune-mediated inflammation reactions. It is for the treatment of psoriasis in dermatology that biological drugs were first used.

AIM: is to assess the development of theoretical and practical approaches to the use of biological drugs for the treatment of psoriasis. The analysis of literature data is carried out. We studied the sources of Russian and foreign literature on the biological therapy of psoriasis, published from 2004 to 2019.

RESULTS: Based on a systematic assessment of the experience of clinical use of biological therapy of psoriasis, the historical aspects of improving the points of application of drugs are studied. The first drugs were targeted by T cells, which were assigned a leading role in the development of psoriasis, then by pro-inflammatory cytokines: TNFa, later -- IL-12 and IL-23. However, uncontrolled inhibition of the basic components of the immune defense could lead to side effects in the form of reactivation of infectious processes in the body, a decrease in antitumor activity. Modern drugs have become highly selective, their point of application is inhibition of the A-17 receptor. An assessment of the evolution of medicines registered in the Russian Federation and in the United States was carried out.

CONCLUSION: A comparative assessment of the therapeutic response to biological therapy according to the PASI index showed that the netakimab as well as secucinumab and icsecizumab demonstrates low immunogenicity and high therapeutic effect in patients with severe forms of psoriasis.

Full Text

Restricted Access

About the authors

E. V. Fayzullina

Kazan State Medical University

Author for correspondence.
Email: elenafs@mail.ru
ORCID iD: 0000-0002-5918-2596

Professor, Doctor of Medicine, Professor of the Department of Dermatovenereology, Kazan State Medical University of the Ministry of Health of the Russian Federation, Honored Doctor of the Republic of Tatarstan, dermatovenerologist of the highest qualification category

Russian Federation, Kazan

A. R. Marsina

Kazan State Medical University

Email: info@eco-vector.com
ORCID iD: 0000-0003-4117-8385

6th year student of the Faculty of General Medicine, Kazan State Medical University, Ministry of Health of the Russian Federation

Russian Federation, Kazan

Irina Khismatulina

Kazan State Medical University

Email: xomenko-aa@mail.ru
ORCID iD: 0000-0002-7781-7786
SPIN-code: 6331-4234

Associate Professor at the Department of Dermatovenereology

Russian Federation, Kazan

G. M. Zinatulina

Kazan State Medical University

Email: info@eco-vector.com
ORCID iD: 0000-0002-3830-1437

dermatovenerologist, Department of Dermatovenereology, Kazan State Medical University

Russian Federation, Kazan


  1. Kubanova AA, Kubanov AA, Znamenskay LF, Chikin VV, Bakulev AL, Khobeych MM, et al. Psoriasis. In: Federal clinical guidelines. Dermatovenerology, 2015. Moscow: Russian Society of Dermatovenereologists and Cosmetologists; 2016:415-70. (in Russian)
  2. Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol. 2017;31(2):205-12.
  3. Оlisova OYu. Psoriasis: epidemiology, pathogenesis, clinic, treatment. Consilium Medicum. Dermatology. Russian Journal. 2010;(4):3-8. (in Russian)
  4. Suskova VS, Pinson IYa, Olisova OYu. Immunopathological mechanisms of psoriasis. Russian Journal of Clinical Dermatology and Venereology. 2006;4(1):68-70. (in Russian)
  5. Nestle FO, Kaplan DH, Barker J. Mechanisms of Disease: Psoriasis. N Engl J Med. 2009;361(5):496-509. Available at: https://psoranet.org/uploads/983747221.pdf Access: 01 Dec 2020
  6. Siegfried S, Ropke M. The biological rationale for use of vitamin d analogs in combination with corticosteroids for the topical treatment of plaque psoriasis. J Drugs Dermatol. 2013;12(8):e129-37. Available at: https://www.pubfacts.com/detail/23986173/The-biological-rationale-for-use-of-vitamin-d-analogs-in-combination-with-corticosteroids-for-the-topical-treatmen-of-plaque-psoriasis. Access: 01 Dec 2020.
  7. Nast A, Boehncke WH, Mrowietz U, Ockenfels HM, Philipp S, Reich K, et al.; Deutsche Dermatologische Gesellschaft (DDG); Berufsverband Deutscher Dermatologen (BVDD). S3 – Guidelines on the treatment of psoriasis vulgaris (English version). J Dtsch Dermatol Ges. 2012;10(Suppl 2):S1-95. doi: 10.1111/j.1610-0387.2012.07919.x.
  8. He Q, Chen HX, Li W, Wu Y, Chen SJ, Yue Q, et al. IL-36 cytokine expression and its relationship with p38 MAPK and NF-kB pathways in psoriasis vulgaris skin lesions. J Huazhong Univ Sci Technolog Med Sci. 2013;33(4):594-9.
  9. Botkina AS, Korotkiy NG, Korotkiy VN. Targeted therapy of psoriatic disease. Russian Journal of Clinical Dermatology and Venereology. 2018;17(4):18-29. (in Russian)
  10. Bakulev AL, Samtsov AV, Kubanov AA, Khairutdinov VR, Kokhan MM, Artemyeva AV, et al. Long-term efficacy and safety of Netakimab in patients with moderate-to-severe psoriasis. Results of phase II open-label extension clinical study BCD-085-2-EXT. Vestnik Dermatologii i Venereologii. Russian Journal. 2019;95(3):54-64. (in Russian)
  11. New drugs for the treatment of immune-related diseases. Provizor. 2004;(21). Available at: http://www.provisor.com.ua/archive/2004/N21/art_06.php. Access: 01 Dec 2020 (in Russian)
  12. National Psoriasis Foundation. Amevive (alefacept) voluntarily discontinued in the U.S. Available at: https://www.psoriasis.org/media/press-releases/amevive-alefacept-voluntarily-discontinued-usa Access: 01 Dec 2020.
  13. Kungurov NV, Keniksfest YuV, Grishaeva EV, Kokhan MM. Clinical experience of using Ixekizumab in treatment of a female patient with severe psoriasis and psoriatic arthritis, resistant to the therapy. Lechasсhi Vrach. Russian Journal. 2020;(5):42-7. https://doi.org/10.26295/OS.2020.20.45.008 (in Russian)
  14. Instructions for medical use of the drug Efalizumab. Available at: https://www.rlsnet.ru/mnn_index_id_3784.htm. Access: 01 Dec 2020 (in Russian)
  15. Instructions for medical use of the drug Etanerceptum (Etanercept). Available at: https://www.rlsnet.ru/mnn_index_id_5482.htm. Access: 01 Dec 2020 (in Russian)
  16. Budanov YuI. Monoclonal antibodies. Use in the diagnosis of diseases and therapeutic monoclonal antibodies. Methodological recommendations. Tver: Tver State Medical Academy; 2012. Available at: https://metodichka.x-pdf.ru/15biologiya/183111-1-monoklonalnie-antitela-ispolzovanie-diagnostike-zabolevaniy-lechebnie-monoklonalnie-antitela-tekst-metodicheskie.php Access: 01 Dec 2020 (in Russian)
  17. Thaci D, Puig L, Reich K, Tsai TF, Tyring S, Kingo K, et al. Secukinumab demonstrates sustained efficacy in clearing skin and improving patient-reported outcomes in patients with moderate-to-severe psoriasis through 2 years of treatment: Results from the CLEAR study. .J Am Acad Dermatol. 2019;81(6):1405-9. doi: 10.1016/j.jaad.2019.04.045.
  18. Olisova OYu. Teplyuk NP, Pinegin VB. Modern methodes of psoriasis treatment. Russian Journal of Medicine. 2015;(9):483-6. (in Russian)
  19. Armstrong AW, Siegel MP, Bagel J, Boh EE, Buell M, Cooper KD, et al. From the Medical Board of the National Psoriasis Foundation: treatment targets for plaque psoriasis. J Am Acad Dermatol. 2017;76(2):290-8.
  20. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CEM, Nast A, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303(1):1-10.
  21. Bozek A, Reich A. The reliability of three psoriasis assessment tools: Psoriasis area and severity index, body surface area and physician global assessment. Adv Clin Exp Med. 2017;26(5):851-6.
  22. Bakulev AL. Evolution of the understanding of psoriasis and therapeutic approaches used to manage such patients. BCD-085 is the first Russian genetically-engineered biological preparation for the treatment of patients suffering from psoriasis. Bulletin of Dermatology and Venereology. Russian Journal. 2018;94(5):26-32. (in Russian)
  23. Samtsov AV, Khairutdinov VR, Bakulev AL, Kubanov AA, Karamova AE, Artemyeva AV, Korotaeva TV. Efficacy and safery of BCD-085, a novel interleukin-17 inhibitor. Result of phase II clinical trial in patients with moderate-to-severe plaque psoriasis. Bulletin of Dermatology and Venereology. Russian Journal. 2017;93(5):52-63. (in Russian)
  24. Visconti MJ, Bashyam AM, Feldman SR. Treatment decisions in psoriasis. J Comp Eff Res. 2019;8(12):947-9.
  25. Mrowietz U. Implementing treatment goals for successful long-term management of psoriasis. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2):12-20.
  26. Olisova OYu, Svistunova DA, Chernyavskaya LM, Anpilogova EM. Phosphodiesterase-4 inhibitor in the treatment of psoriasis and psoriatic arthritis. Bulletin of Dermatology and Venereology. Russian Journal. 2019;95(2):74-80. (in Russian)

Supplementary files

Supplementary Files
1. Pic.

Download (443KB)

Copyright (c) 2020 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: 015912 от 28.03.1997 г
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80653 от 15.03.2021 г

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies