Опыт применения Нетакимаба и агониста ГПП-1 у пациентов с псориазом и метаболическим синдромом

Понимание патогенетической взаимосвязи псориаза и ожирения имеет ключевое значение, поскольку избыточный вес может снижать эффективность препаратов, что подчёркивает его клиническую значимость не только в контексте тяжести заболевания, но и в отношении терапевтических исходов, в том числе при применении генно-инженерной биологической терапии. Агонисты рецепторов глюкагоноподобного пептида-1 (АР ГПП-1) представляют собой класс препаратов, воздействующих на пути инкретиновых гормонов, нормализующих метаболические нарушения. На сегодняшний день опубликованы клинические исследования, посвященные применению агонистов ГПП-1 у пациентов с псориазом. В этом аспекте актуальным является изучение комплексного применения генно-инженерных препаратов и агонистов ГПП-1 у пациентов с псориазом и ассоциированным метаболическим синдромом.

Материал и методы. Под наблюдением находилось 12 пациентов с псориазом и метаболическим синдромом. Всем пациентам был назначен нетакимаб 120 мг и тирзепатид в соответствии с инструкцией.

Результаты. При оценке индекса PASI в динамике до лечения и на 26 неделе отмечались статистически значимые изменения (p<0,001): достижение PASI 90 и 100 у всех пациентов, что свидетельствует о выраженном клиническом ответе на проводимую терапию. В исследуемой группе медиана снижения массы тела составила 14 кг (95 % ДИ: 12,00–15,00), при этом минимальное снижение составило 10 кг, максимальное 15 кг. В процентном отношении среднее снижение массы тела составило 13,02±1,23.

Выводы. Комплексный подход к терапии пациентов с тяжелым псориазом и ассоциированным метаболическим синдромом с выраженным избытком массы тела является наиболее целесообразной стратегией, так как данная категория пациентов находится в зоне риска недостаточного ответа на генно-инженерные препараты. В данном наблюдательном исследовании была показана высокая эффективность и безопасность применения генно-инженерного препарата из группы блокаторов ИЛ-17А (нетакимаб) и тирзепатида.

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