Comparative assessment of the dynamics of laboratory markers of endothelial dysfunction in patients with psoriasis under the influence of methotrexate and inhibitor IL-17A Netakimab.

Objective. Сomparative assessment of the clinical effect of the IL-17 inhibitor Netakimab and Methotrexate on the values ​​of laboratory markers of endothelial dysfunction in patients with psoriasis in comparison with the dynamics of clinical efficacy indicators over 6 months of therapy.

Subjects and methods. The work is based on data from dynamic observation of 66 patients with PsA who were first prescribed Methotrexate and Netakimab: patients in group 1 (30 patients) received Methotrexate 15 mg per week subcutaneously in combination with Folic acid 5 mg per week; patients in group 2 (36 patients) received Netakimab 120 mg subcutaneously according to the following regimen: weeks 0, 1 and 2, then once every 4 weeks. Analysis of clinical data was carried out before the start of treatment and after 3 and 6 months. All patients underwent a study of plasma concentrations of vascular endothelium factors (VEGF), endothelina-1 (En-1) and nitrogen oxide (NO) before the start of treatment and after the third month of therapy.

Results and discussion.

In patients with psoriasis, compared with the control group, increased plasma levels of endothelial dysfunction markers were registered: VEGF (19.8 [4.5; 49.4] pg/ml versus 5.2 [0.5; 9.8] pg/ml ml, p=0.004), En-1 (286.4 [154; 439] pg/ml vs. 96.5 [32; 188] pg/ml, p=0.002) and OA (4.3 [2.1; 12.5] pg/ml and against 2.2 [0.2; 5.0] pg/ml, p=0.02). By the end of the third month of therapy, a decrease in the levels of the VEGF, En-1 and NO was noted. The differences in the values ​​of the following indicators of endothelial dysfunction before treatment and three months after the start of treatment were more pronounced in group 2 of patients taking Netakimab: a decrease in the concentration of VEGF by 10.2 [8.4; 13.7] compared to 7.0 [5.6; 11.7] (p=0.043) in group 1 of patients and En-1 by 184.6 [167; 202] compared to 112.7 [97; 136] (p=0.008) in group 1 of patients. It was detected that in patients of group 2, a more pronounced decrease in the PASI and NAPSI indices was achieved compared with patients of group 1 during 3 and 6 months after treatment starting.

Conclusion. The work demonstrated the ability of the IL-17 inhibitor Netakimab to reduce initially elevated values ​​of laboratory markers of endothelial dysfunction.