Evolution of biological therapy for psoriasis: realities and prospects

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Abstract

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.

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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

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