Vliv dlouhodobé terapie adalimumabu na biomarkery systémového zánětu u psoriázy

Czech version English version

: S. Gkalpakiotis ¹; P. Arenberger ¹; S. Tivadar ¹; P. Gkalpakioti ¹; J. Potočková ²; P. Kraml ²
: Dermatovenerologická klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, přednosta prof. MUDr. Petr Arenberger, DrSc, MBA, FCMA ¹; Interní klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, přednosta prof. MUDr. Ivan Rychlik, CSc., FASN, FERA ²
: Čes-slov Derm, 96, 2021, No. 4, p. 179-185
: Pharmacologyand Therapy, Clinical Trials

Pacienti s psoriázou jsou vystaveni zvýšenému riziku aterosklerózy, která je charakterizovaná endotelovou dysfunkcí spojenou se systémovým zánětem. Zdá se, že léčba anti-tumor nekrotizujícím faktorem alfa (anti-TNF-a) může toto riziko snížit. Účelem studie bylo změřit hladiny sérových markerů asociovaných se systémovým zánětem u pacientů s psoriázou v porovnaní se zdravými jedinci a dále zhodnotit změnu jejich hladin po 3 měsících a 2 letech při léčbě anti-TNF alfa adalimumabem. Zkoumali jsme čtyři biomarkery: vysoce senzitivní C-reaktivní protein (hsCRP), oxidovaný lipoprotein s nízkou hustotou (OxLDL), E-selektin a Interleukin 22 (IL-22). Tyto markery byly stanoveny u zdravých dobrovolníků a u 28 pacientů se středně těžkou až těžkou psoriázou před léčbou a po 3 a 24 měsících léčby adalimumabem. Pacienti s psoriázou měli zvýšené hladiny markerů ve srovnání s kontrolní skupinou. Po 3 měsících léčby významně poklesl E-selektin (p < 0,001), stejně tak IL-22 (p < 0,001). HsCRP pokleslo také, ale statisticky nevýznamně, OxLDL byl lehce vyšší než původně. Po 24 měsících bylo 17 pacientů stále léčeno adalimumabem. U těchto pacientů hsCRP (p < 0,05), E-selektin (p < 0,001) a IL-22 (p < 0,001) byly signifikantně snížené. Hodnota OxLDL zůstala zvýšena. Stabilní pokles E-selektinu, hsCRP a IL-22 po 24 měsících potvrzuje, že adalimumab potlačuje systémový zánět.

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Zápis ze schůze výboru ČDS konané dne 17. 6. 2021

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Czech-Slovak Dermatology

2021 Issue 4