Russian Journal of Skin and Venereal DiseasesRussian Journal of Skin and Venereal DiseasesРоссийский журнал кожных и венерических болезней1560-95882412-9097Eco-Vector7948110.17816/dv79481DERMATOLOGYДЕРМАТОЛОГИЯResearch ArticleIL-17A in the treatment of nail psoriasisИнгибиторы ИЛ-17А в лечении псориаза ногтейhttps://orcid.org/0000-0003-2482-17542500-7989OlisovaOlga Yu.ОлисоваОльга Юрьевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

olisovaolga@mail.ruhttps://orcid.org/0000-0002-4674-8327NikuradzeVictoria O.НикурадзеВиктория Олеговна
Russian Federation

Graduate Student

аспирант

victorianikuradze@gmail.comhttps://orcid.org/0000-0002-7635-6260KorolevaMaria A.КоролеваМария Александровна
Russian Federation
victorianikuradze@gmail.comI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)Central Clinical Hospital of the Management Affair of President Russian FederationЦентральная клиническая больница с поликлиникой Управления делами Президента Российской Федерации150720212443473540309202102122021Copyright ©; 2021, Eco-VectorCopyright ©; 2021, ООО "Эко-Вектор"2021Eco-VectorООО "Эко-Вектор"https://rjsvd.com/1560-9588/article/view/79481

BACKGROUND: Psoriasis is an inflammatory skin disease that significantly worsens the quality of the patients’ life. With vulgar psoriasis, the most common form of the disease, nail damage is observed in more than 50% of cases.

AIMS: To evaluate the efficacy and tolerability of secukinumab in the treatment of nail psoriasis (psoriatic onychodystrophy) in real clinical practice.

MATERIALS AND METHODS: The study was carried out on the basis of the Clinic for Skin and Venereal Diseases. V.A. Rakhmanov Sechenov University. The participants were 12 patients diagnosed with psoriasis, aged 29 to 60 years. All patients were diagnosed with a severe degree, 2 (16.7%) patients ― psoriatic erythroderma, 10 (83.3%) ― psoriasis vulgaris, all studied patients had nail plate lesions. All patients were treated with a genetically engineered biological drug ― an IL-17A inhibitor secukinumab (Cosentix), 300 mg subcutaneously once a week (5 injections), followed by a maintenance dose of 300 mg once a month. The course of therapy was 20 weeks (9 injections). Assessment of the severity of nail psoriasis and the effectiveness of therapy was carried out using indices: NAPSI (index of the degree of damage to the nail plates), DLQI (dermatological index of quality of life), which were studied in dynamics before treatment and after 20 weeks of treatment.

RESULTS: The NAPSI index was 25.3±3.4 points before treatment, and at week 20 it decreased to 2.2±0.7 points. These results demonstrate a regression of clinical manifestations by more than 80% from the initial state of the nails. When assessing the dermatological index of quality of life (DLQI), it was found that in the study group of patients before the start of treatment, it was 27.4±2.1 points, which reflected a strong negative effect of psoriasis on the quality of life of patients. After treatment, this indicator was 3.1±0.5 points among all patients. No patient experienced any side effects from the therapy.

CONCLUSIONS: Secukinumab is a highly effective and safe drug for the treatment of nail psoriasis in patients with vulgar psoriasis and psoriatic erythroderma and contributes to improve the quality of the patients’ life.

Обоснование. Псориаз ― воспалительное заболевание кожи, значительно ухудшающее качество жизни пациетов. При вульгарном псориазе, наиболее распространённой форме заболевания, поражение ногтей наблюдается более чем в 50% случаев.

Цель ― оценка эффективности и переносимости секукинумаба при лечении псориаза ногтей (псориатической ониходистрофии) в реальной клинической практике.

Материал и методы. Исследование проведено на базе клиники кожных и венерических болезней им. В.А. Рахманова Сеченовского Университета. Участниками являлись 12 пациентов с диагнозом «псориаз» в возрасте от 29 до 60 лет. У всех пациентов была диагностирована тяжёлая степень, у 2 (16,7%) — псориатическая эритродермия, у 10 (83,3%) — вульгарный псориаз; у всех исследуемых пациентов наблюдалось поражение ногтевых пластин. Всем пациентам проводилось лечение генно-инженерным биологическим препаратом — ингибитором ИЛ-17А секукинумабом в дозе 300 мг подкожно. Курс терапии составил 20 нед. (9 инъекций). Оценка степени тяжести псориаза ногтей и эффективности терапии проводилась с помощью индексов NAPSI (индекс степени поражения ногтевых пластин), DLQI (дерматологический индекс качества жизни), которые изучали в динамике ― до лечения и спустя 20 нед.

Результаты. Индекс NAPSI до лечения составлял 25,3±3,4 балла, а на 20-й нед. снизился до 2,2±0,7 балла, что демонстрирует регресс клинических проявлений более чем на 80% от изначального состояния ногтей. Дерматологический индекс качества жизни (DLQI) у исследуемой группы до начала лечения составлял 27,4±2,1 балла, что отражало сильное негативное влияние болезни на качество жизни пациентов. После лечения показатель у всех пациентов снизился до 3,1±0,5 балла. Побочных эффектов от проводимой терапии не отмечено ни у одного больного.

Заключение. Секукинумаб является высокоэффективным и безопасным препаратом для лечения псориаза ногтей у больных вульгарным псориазом и псориатической эритродермией и способствует улучшению качества жизни пациентов.

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