BIOLOGIC DRUGS IN THE TREATMENT OF PSORIATIC ARTHRITIS
Summary. Summary. The present review substantiates actuality of the investigations for new approaches in psoriatic arthritis treatment with biologic drugs. The common presentation about immunopathogenesis of the disease with emphasis on importance of target therapy development aimed to leading links of psoriatic joint involvement pathogenesis is given. Particularly, the review provides information about complex mechanism of psoriatic process including interaction of plasmacytoid and activated dendritic cells, Th1 and Th17 lymphocytes and numerous mediators of inflammation. The main criteria of objective estimation of therapeutic effects are delighted the most accepted of which are American College of Rheumatology achievement index, PASI and PSARC. The results of certain studies of tumor necrosis factor inhibitors (etanercept, adalimumab, infliximab, golimumab, certolizumab pegol) and overall estimation of their clinical efficiency. A special attention was paid to interleukin inhibitors playing an important role in pathogenesis of the disease, especially to ustekinumab, brodalumab and phosphodiestarse-4 inhibitor apremilast. It was noted clinical efficiency and safety of biologics along with perspective of these drug study in psoriatic arthritis treatment on the basis of available data obtaining from completed controlled trials. Moreover, potential interest of investigation of other biologic agents was emphasized for psoriatic joint lesions treatment including interleulin-17 inhibitors (secukinumab, ixekizumab), Janus kinase inhibitor (tofacitinib), and protein kinase C inhibitor (sotrastaurin).
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