[脊柱关节炎的当前治疗方法:聚焦奈达单抗。 综述]。

Pub Date : 2024-06-03 DOI:10.26442/00403660.2024.05.202794
D E Karateev, E L Luchikhina
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引用次数: 0

摘要

脊柱关节炎(Spondyloarthritis,SPA)是一组风湿性疾病,包括强直性脊柱炎(ankylosing spondylitis,AS)、银屑病关节炎(psoriatic arthritis,PsA)和其他一些疾病。脊柱关节炎是一种常见病,主要在年轻时发病,严重损害了最活跃人群的工作能力和社会交往能力,因此导致了严重的社会问题。对于所有主要类型的慢性进行性脊柱炎而言,生物制剂(生物制剂)对接受标准治疗后仍持续活动的患者具有重要意义,尤其是在主要受累于轴的情况下,因为在这种情况下,除了持续使用非甾体抗炎药(NSAIDs)外,生物制剂实际上是有效治疗的唯一选择。在过去十年中,白细胞介素-17A(IL-17A)抑制剂在 SpA 治疗中占据了首位,因为根据现代发病机制的观点,IL-17A 可能是 SpA 治疗干预的关键靶点。为了确保俄罗斯的 SpA 患者能够得到治疗,引进 IL-17A 抑制剂 Netakimab(NTK)这类原创药物尤为重要。本综述介绍了NTK在AS和PsA中的I、II、III期随机临床试验数据,以及IV期注册后观察研究数据,包括对特别关注的亚群患者,尤其是银屑病性脊柱炎患者的分析。在随机临床试验和临床实践中,NTK 均显示出治疗 SpA 的高度有效性。该药物的特点是临床作用起效迅速,并能持续保持已取得的改善效果,对疾病的各种表现具有复杂的影响,能够产生结构调整作用,并能减缓侵蚀过程和骨质增生的进展。NTK 的安全性在所有 IL-17 抑制剂中具有代表性。这种药物的免疫原性很低,因此可以保证多年的有效使用。专家委员会关于在 AS 和 PsA 中使用 NTK 的决议支持将这种药物纳入临床指南。
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[Current treatment for spondyloarthritis: focus on netakimab. A review].

Spondyloarthritis (SpA) is a group of rheumatic diseases that includes ankylosing spondylitis (AS), psoriatic arthritis (PsA) and a number of other diseases. SpA lead to a significant social problem, since it is a common pathology that debuts mainly at a young age, significantly impairing the ability to work and the ability to social contacts of the most active part of the population. For all the main types of chronic progressive SpA, biological agents (biologics) are of great importance in patients with persistent activity despite standard treatment, especially in the case of predominantly axial involvement, since in this case it is actually the only option for effective treatment, in addition to the constant use of non-steroidal anti-inflammatory drugs (NSAIDs). Over the past decade, interleukin-17A (IL-17A) inhibitors have taken the first place in therapy of SpA, because, according to modern ideas about pathogenesis, IL-17A may be a key target for therapeutic intervention in SpA. In terms of ensuring availability for Russian patients with SpA, it is of particular importance to the introduction of the original medication from the group of IL-17A inhibitors Netakimab (NTK). This review presents data from randomized clinical trials of NTK phases I, II and III in AS and PsA also post-registration observational studies of phase IV, including analysis of subpopulations of patients of special interest, in particular, patients with psoriatic spondylitis. NTK demonstrated high effectiveness in the treatment of SpA both in randomized clinical trials and in clinical practice. The drug is characterized by a rapid onset of clinical action and persistent maintenance of the achieved improvement, a complex effect on various manifestations of the disease, is able to have a structure-modifying effect and slow down the progression of both the erosive process and osteoproliferation. The safety profile of NTK is generally typical for the entire group of IL-17 inhibitors. The drug has low immunogenicity, which allows us to count on the possibility of many years of effective use. Resolutions of expert councils on the use of NTK in AS and PsA support the inclusion of this drug in clinical guidelines.

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