medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-8-8-14medalphabet-4347Research ArticleСтатьиПсориаз, коморбидное ожирение и эффективность ингибитора ИЛ‑23 гуселькумаба на примере клинических случаевPsoriasis, comorbid obesity, and the efficacy of the IL‑23 inhibitor guselkumab based on clinical caseshttps://orcid.org/0000-0002-3798-3341ВладимироваИ. С.VladimirovaI.  S.

Владимирова Ирина Сергеевна, к.м.н., врач-дерматовенеролог; старший преподаватель кафедры кожных и венерических болезней

Санкт-Петербург

Vladimirova Irina S., PhD Med, dermatovenerologist; senior lecturer at Dept of Skin and Venereal Diseases

St. Petersburg

ivladimirva@rambler.ruhttps://orcid.org/0000-0002-5044-5265КругловаЛ. С.KruglovaL. S.

Круглова Лариса Сергеевна, д.м.н., проф., ректор, зав. кафедрой дерматовенерологии и косметологии

Санкт-Петербург

Kruglova Larisa S.,DM Sci (habil.), professor, rector, head of Dept of Dermatovenereology and Cosmetology

Moscow

https://orcid.org/0009-0005-7959-9750БермасА. Ю.BermasA. Yu.

Бермас Александра Юрьевна, студентка 6 курса

Санкт-Петербург

Bermas Alexandra Yu., 6th year student

St. Petersburg

БондарьО. И.BondarO. I.

Бондарь Остап Игоревич, к.м.н., главный врач; доцент кафедры кожных и венерических болезней

Санкт-Петербург

Bondar Ostap I., PhD Med, chief physician1, associate professor at Dept of Skin and Venereal Diseases

St. Petersburg

СПб ГБУЗ «Кожно-венерологический диспансер № 10 – Клиника дерматологии и венерологии»; ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской ФедерацииРоссияSkin and Venereal Diseases Dispensary No. 10 – Clinic of Dermatology and Venereology; S.M. Kirov Military Medical AcademyRussian FederationФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Presidential Administration of the Russian FederationRussian FederationФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской ФедерацииРоссияS.M. Kirov Military Medical AcademyRussian Federation20250406202508Дерматология (1)814Copyright © Владимирова И.С., Круглова Л.С., Бермас А.Ю., Бондарь О.И., 20252025Владимирова И.С., Круглова Л.С., Бермас А.Ю., Бондарь О.И.Vladimirova I.S., Kruglova L.S., Bermas A.Y., Bondar O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4347

Данные эпидемиологических исследований демонстрируют тесную связь псориаза с сопутствующими метаболическими заболеваниями, включающие ожирение, гипертоническую болезнь, сахарный диабет, дислипидемию и неалкогольную жировую болезнь печени. Наличие сопутствующих метаболических заболеваний оказывает существенное влияние навыбор и эффективность фармакологического лечения. Из-за повышенного риска развития нежелательных явлений упациентов спсориазом и коморбидностями некоторые препараты необходимо назначать с особой осторожностью, в то же время часть препаратов показывают низкую эффективность. Ингибитор ИЛ‑23 гуселькумаб может выступать лучшей терапевтической альтернативой для пациентов с псориазом и метаболическими расстройствами, включая ожирение, по сравнению с базисными противовоспалительными препаратами (таких как метотрексат, ацитретин) и другими классами биологических препаратов. У пациентов со среднетяжелым и тяжелым псориазом ингибитор ИЛ‑23 гуселькумаб показывает высокий результат лечения с достижением PASI 90 и PASI 100, независимо от ИМТ. В представленной публикации описаны наблюдения пациентов со среднетяжелым и тяжелым псориазом, коморбидностями и высокой эфффективностью генно-инженерной биологической терапии ингибитором ИЛ‑23 (гуселькумабом).

Epidemiological studies demonstrate a close relationship between psoriasis and concomitant metabolic diseases, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of concomitant metabolic diseases has a significant impact on the choice and effectiveness of pharmacological treatment. Due to the increased risk of adverse events in patients with psoriasis and comorbidities, some drugs should be prescribed with special caution, while some drugs show low efficacy. The IL‑23 inhibitor guselkumab may be a better therapeutic alternative for patients with psoriasis and metabolic disorders, including obesity, compared with disease-modifying antirheumatic drugs (such as methotrexate, acitretin) and other classes of biological drugs. In patients with moderate to severe psoriasis, the IL‑23 inhibitor guselkumab shows a high treatment outcome with PASI 90 and PASI 100 achieved, regardless of BMI. The presented publication describes observations of patients with moderate to severe psoriasis, comorbidities and high efficiency of genetically engineered biological therapy with an IL‑23 inhibitor (guselkumab).

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The authors declare that there are no conflicts of interest present.