Experience of using the interleukin-17A inhibitor secukinumab in the treatment of psoriasis and psoriatic arthritis

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Abstract

Psoriasis is a chronic immune-inflammatory skin disease, which in 25–30% of cases occurs in combination with damage of the musculoskeletal system ― psoriatic arthritis. Nowadays, the leading role in the pathogenesis of psoriasis and psoriatic arthritis is assigned to the activation of the IL-23/IL-17 axis-key cytokines involved in the activation pathway of the effector activity of Th17 lymphocytes. The activity of proinflammatory cytokines secreted by Th17 cells in psoriasis and psoriatic arthritis is also confirmed by the high efficiency of targeted therapy aimed specifically at this pathway. One of the modern genetically engineered biological drugs blocking IL-17 which is used worldwide in the treatment of psoriasis and psoriatic arthritis is secukinumab, a recombinant, fully human monoclonal antibody of high affinity directed against IL-17A.

The article presents data from own 52-week follow-up of secukinumab use in 40 patients with severe and moderate-severe psoriasis which was combined with psoriatic arthritis in 67.5% of cases and demonstrates high efficacy, survival and satisfactory tolerability of this therapy.

About the authors

Yulia V. Molochkova

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Email: yulia.molochkova@yandex.ru
ORCID iD: 0000-0001-9021-6494
SPIN-code: 2051-0250

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

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Marina S. Petrova

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Author for correspondence.
Email: marina.s.petrova@gmail.com
ORCID iD: 0000-0002-1789-2311
SPIN-code: 7797-1699
Russian Federation, 61/2 Shepkina street, 129110 Moscow

Vladimir A. Molochkov

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Email: vlmolochkov@yandex.ru
ORCID iD: 0000-0003-3388-9224
SPIN-code: 2215-1337

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

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Maria K. Monaenkova

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Email: mar.monaenkova@gmail.com
ORCID iD: 0000-0001-8479-1978
SPIN-code: 9662-8661
Russian Federation, 61/2 Shepkina street, 129110 Moscow

Elizaveta D. Abalukhova

Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky

Email: ladybird2016@gmail.com
ORCID iD: 0009-0003-5831-4977
Russian Federation, 61/2 Shepkina street, 129110 Moscow

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Supplementary files

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2. Fig. 1. The spectrum of concomitant diseases in patients with psoriasis (n=40).

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3. Fig. 2. Therapy options in anamnesis in patients with psoriasis (n=40). ГИБТ ― genetically engineered biological therapy; ПУВА ― phototherapy (ultraviolet A spectrum) with simultaneous application of psoralens (photoactive substance).

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4. Fig. 3. Dynamics of the average PASI (0–52 weeks), score.

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5. Fig. 4. Dynamics of the average NAPSI (week 0–52), score.

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6. Fig. 5. Dynamics of the average BASDAI (week 0–52), score.

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7. Fig. 6. Dynamics of the decrease in the average value of C-reactive protein (week 0–52), mg/l.

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8. Fig. 7. Dynamics of the average value of DLQI (0–52 weeks), score.

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9. Fig. 8. Patient T., 44 years old. Psoriatic erythroderma: the skin is hyperemic, infiltrated, heavy scalling, linear cracks.

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10. Fig. 9. Pronounced positive dynamics after 12 weeks of secukinumab therapy.

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11. Fig. 10. Almost complete regression of rashes after 16 weeks of secukinumab therapy.

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