Early administration of genetically engineered biological agents as effective secondary prevention of psoriatic arthritis

Failure to promptly detect early signs of structural damage in PsA can lead to the development of serious irreversible joint damage, which in turn can cause disability and a significant reduction in quality of life. Furthermore, late detection of PsA is associated with a significant reduction in the effectiveness of therapy. Therefore, the importance of early, active treatment, including the use of biologic agents, for secondary prevention of PsA is now clear. This treatment aims to slow progression and prevent disability.
Material and methods. The study included 21 patients with glabrous psoriasis, as well as those with early signs of psoriatic arthritis, particularly with axial lesions affecting the spine and sacroiliac joints. Treatment with netakimab was administered according to the following regimen: 120 mg at weeks 0, 1, and 2, then 120 mg of netakimab monthly for 52 weeks.
Results. By week 52, 95.24% of patients achieved a PASI of 100. Magnetic resonance imaging (MRI) of the sacroiliac joints using the STIR mode revealed no signs of active inflammation by week 12 of therapy in 85.71% of patients. Cervical spine radiography also showed no structural damage. Netakimab significantly reduced axial manifestations of Ps A. All patients reported a reduction in inflammatory back pain by week 12 of treatment, as evidenced by changes in the BASDAI score.
Conclusions. The strategy of early administration of biologic agents such as netakimab to patients with severe and moderate skin psoriasis and early signs of PsA in the back appears justified. This strategy may help prevent disability, a significant reduction in quality of life, and irreversible changes in joints. Furthermore, this therapy helps reduce systemic inflammation, which may be considered an important aspect of secondary prevention of the development of severe forms of psoriatic arthritis in the future.

1. Nasonov EL. Achievements of rheumatology in the 21st century. Scientific and practical rheumatology. 2014; 52 (2): 133–140. (In Russ.).

2. Nasonov EL. Progress of rheumatology at the beginning of the 21st century. Modern rheumatology. 2014; (3): 4–8. (In Russ.).

3. Lila A.M. et al. Social significance of rheumatic diseases, negative consequences for the healthcare system and ways of prevention // Real clinical practice: data and evidence. 2025; 5 (2): 5–15. (In Russ.).

4. Sihvonen S. et al. Death rates and causes of death in patients with rheumatoid arthritis: a population based study //Scandinavian journal of rheumatology. 2004; 33 (4): 221–227.

5. Peyrin Biroulet L, Sandborn W, Sands BE, et al. Selecting Therapeutic Targets inInflammatory Bowel Disease (STRIDE): determining therapeutic goals for treat to target. Am J Gastroenterol. 2015 Sep; 110 (9): 1324–38. DOI: 10.1038/ajg.2015.233. Epub 2015 Aug 25.

6. Coates L, Lubrano E, Perrotta F, et al. What Should Be the Primary Target of «Treat to Target» in Psoriatic Arthritis? J Rheumatol. 2019 Jan; 46 (1): 38–42. DOI: 10.3899/jrheum.180267. Epub 2018 Sep 15.

7. Mahil SK, Wilson N, Dand N, et al. Psoriasis treat to target: defining outcomes in psoriasis using data from a real-world, popu- lation-based cohort study (the British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR).Br J Dermatol. 2020 May; 182 (5): 1158–66. DOI: 10.1111/bjd.18333. Epub 2019 Sep 10

8. Takeshita J. Taking aim at identifying treatment targets for psoriasis. Br J Dermatol. 2020 May; 182 (5): 1075–76. DOI: 10.1111/ bjd.18635

9. Kavanaugh A, van der Heijde D, Beutler A, et al. Radiographic progression of patients with Psoriatic Arthritis Who achieve Minimal disease activity in response to Golimumab therapy: results through 5 years of a Randomized, Placebo Controlled Study. Arthritis Care Res (Hoboken). 2016 Feb; 68 (2): 267–74. DOI: 10.1002/acr.22576

10. Mease PJ, Kavanaugh A, Coates LC, et al. Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial. RMD Open. 2017 Jul 18; 3 (1): e000415. DOI: 10.1136/rmdopen 2016–000415. eCollection 2017.

11. Coates LC, Mease PJ, Gossec L, et al. Minimal disease activity among active psoriatic arthritis patients treated with Secukinumab: 2 year results from a multicen ter, randomized, double blind, parallel group, placebo controlled phase III study. Arthritis Care Res (Hoboken). 2018 Oct; 70 (10): 1529–35. DOI: 10.1002/acr.23537.Epub 2018 Sep 1.

12. Van Mens LJ, de Jong HM, Fluri I, et al. Achieving remission in psoriatic arthritis by early initiation of TNF inhibition: a double blind, randomised, placebo controlled trial of golimumab plus methotrexate versus placebo plus methotrexate. Ann Rheum Dis. 2019 May; 78 (5): 610–16. DOI: 10.1136/annrheumdis 2018–214746. Epub 2019 Feb 26.

13. Korotaeva TV, Loginova EYu, Getiya TS, Nasonov EL. Results of the «Treat to target» strategy in patients with early psoriatic arthri tis 1 year after the start of therapy: data from the REMARKA study. Terapevticheskii arkhiv. 2018; 90 (5): 22–9. (In Russ.).

14. Abdulganieva DI, Bakulev AL, Belousova EA, et al. Early administration of genetically engineered biological drugs for immunoinflammatory diseases: possibilities and prospects. Expert opinion. Modern Rheumatology. 2020; 14 (3): 7–18. (In Russ.). DOI: 10.14412/1996-7012-2020-3-7-18

15. Pereverzina N.O., Kruglova L.S., Korotaeva T.V. Efficacy and safety of early administration of IL 17A inhibitors in the treatment of axial lesions in patients with skin psoriasis // Russian Journal of Skin and Venereal Diseases. 2023; 26 (1): 13–24. (In Russ.). DOI: https://doi.org/10.17816/dv114932

16. Kruglova, L.S. Efficiency of early administration of interleukin 17 blockers in the treatment of axial lesions in psoriatic arthritis / L.S. Kruglova, N.O. Pereverzina // Farmateka. 202; 14: 22–26. (In Russ.).

17. Kruglova, L.S. Early administration of genetically engineered biological therapy to patients with psoriasis / L.S. Kruglova, A.A. Khotko, M.A. Petriy // Medical alphabet. 2019; 1 (7): 25–28. (In Russ.).

18. Kubanov A.A., Bakulev A.L., Samtsov A.V., Khairutdinov V.R. Netakimab – a new IL 17a inhibitor: results of 12 weeks of the phase III clinical trial BCD 085–7/PLANETA in patients with moderate to severe psoriasis vulgaris. Bulletin of Dermatology and Venereology. 2019. Vol. 95. No. 2. P. 15–28. (In Russ.).

19. Bakulev A.L., Samtsov A.V., Kubanov A.A., Khairutdinov V.R. Long term efficacy and safety of netakimab in patients with moderate to severe psoriasis vulgaris. Results of an open label, extended phase II clinical trial BCD 085–2 ext. Bulletin of Dermatology and Venereology. 2019. Vol. 95. No. 3. P. 54–64. (In Russ.).

20. Korotaeva T.V., Mazurov V.I., Lila A.M., Gaidukova I.Z., Bakulev A.L., Samtsov A.V., Khairutdinov V.R., Eremeeva A.V., Morozova M.A. Efficacy and safety of netakimab in patients with psoriatic arthritis: results of the phase III PATERA clinical trial. Scientific and Practical Rheumatology. 2020; 58 (5): 480–488. (In Russ.).

21. Samtsov A.V., Khairutdinov V.R., Bakulev A.L., Kubanov A.A., Karamova A.E., et al. Efficacy and safety of BCD 085, an original monoclonal antibody against interleukin 17, in patients with moderate to severe psoriasis vulgaris. Results of phase II of an international multicenter comparative randomized double blind placebo controlled clinical trial. Bulletin of Dermatology and Venereology. 2017; 5: 52–63. (In Russ.).

22. Kruglova L.S., Rudneva N.S., Bakulev A.L., Khotko A.A. Inverse psoriasis and psoriasis of “difficult” localizations: the efficacy of netakimab. Medical alphabet. 2022; 1 (27): 14–20. (In Russ.). https://doi.org/10.33667/2078-5631-2022-27-14-20