Využití risankizumabu v léčbě pacienta s těžkou formou artropatické psoriázy
| Title in English | Use of risankizumab in the treatment of a patient with severe arthropathic psoriasis |
|---|---|
| Authors | |
| Year of publication | 2020 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapie |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.farmakoterapie.cz/c6607/vyuziti-risankizumabu-v-lecbe-pacienta-s-tezkou-formou-artropaticke-psoriazy |
| Keywords | risankizumab; arthropathic psoriasis |
| Description | Biological therapy is a modern revolutionary treatment method for a number of inflammatory and oncological diseases. One of the inflammatory diseases in which biological therapy is increasingly used is psoriasis. Risankizumab is the latest biological drug to be registered in the Czech Republic and, from 1 June 2020, to be approved for the treatment of plaque psoriasis. Risankizumab is a humanized IgG1 monoclonal antibody that selectively binds with high affinity to the p19 subunit of the human cytokine interleukin-23 (IL-23) and inhibits its interaction with the IL-23 R receptor complex. The regulatory cytokine IL-23 has been identified as key in pathogenesis psoriasis. IL-23 stimulates the differentiation of naive Th cells into pathogenic Th17 cells. Pathogenic Th17 lymphocytes increasingly produce pro-inflammatory cytokines: interleukin-17 (IL-17), interleukin-22 (IL-22), interferon-GAMA (IFN-GAMA), which maintain pro-inflammatory status, systemic inflammation, and high psoriasis activity. IL-23 blockade leads to selective blockade of differentiation of only pathogenic Th 17 lymphocytes. Non-pathogenic Th 17 lymphocytes continue to differentiate and produce physiological levels of interleukin-10 (IL-10) and IL-17. The physiological level of IL-17 is necessary to maintain the protection of the barrier functions of the skin and mucous membranes against specific pathogens (intracellular, extracellular, parasites, candidates). With selective blockade of IL-23, homeostasis and barrier mucosal function are preserved (Figure 1). The recurrence of the disease is probably related to the production of IL-17 by tissue resident memory T-lymphocytes (TRM), where the cytokines IL-17 and IL-22, both of which are produced by pathogenic Th17 lymphocytes, play an important role. Blockade of IL-23 leads to suppression of TRM lymphocytes, which is likely to activate anti-inflammatory memory and thus prolong the therapeutic response. Due to this mechanism, risankizumab has a long dosing interval. Risankizumab is indicated for the treatment of moderate to severe focal psoriasis in adults who are candidates for systemic therapy. - Risankizumab is given as a subcutaneous injection. The recommended dose is 150 mg (two 75 mg - injections) at week 0, week 4 and every 12 weeks thereafter. |