vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v23i5.2799vsp-3597Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWБолезнь-модифицирующая терапия псориаза в детском возрастеDisease-Modifying Treatment of Psoriasis in Childrenhttps://orcid.org/0000-0003-2252-8570МурашкинН. Н.MurashkinNikolay N.

Мурашкин Николай Николаевич, доктор медицинских наук, профессор, руководитель НИИ детской дерматологии, заведующий отделением дерматологии и аллергологии, заведующий лабораторией патологии кожи у детей отдела научных исследований в педиатрии; профессор кафедры дерматовенерологии и косметологии; профессор кафедры педиатрии и детской ревматологии 

119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Moscow

m_nn2001@mail.ruhttps://orcid.org/0000-0002-6034-8231МатерикинА. И.MaterikinAlexander I.

Москва

Moscow

https://orcid.org/0000-0002-4107-4642ЕпишевР. В.EpishevRoman V.

Москва

Moscow

https://orcid.org/0000-0001-5739-0941ЛеоноваМ. А.LeonovaMariya A.

Москва

Moscow

https://orcid.org/0000-0002-0858-8780ОпрятинЛ. А.OpryatinLeonid A.

Москва

Moscow

https://orcid.org/0000-0001-9777-0156ФедоровД. В.FedorovDmitry V.

Москва

Moscow

https://orcid.org/0000-0002-0081-0981ИвановР. А.IvanovRoman A.

Москва

Moscow

https://orcid.org/0000-0001-6884-5171СавеловаА. А.SavelovAlena A.

Москва

Moscow

https://orcid.org/0009-0003-5367-3268ПавловаЕ. С.PavlovEkaterina S.

Москва

Moscow

НМИЦ здоровья детей; Первый МГМУ им. И.М. Сеченова (Сеченовский Университет); ЦГМА УДП РФРоссияNational Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University; Central State Medical Academy of Department of Presidential AffairsRussian FederationНМИЦ здоровья детейРоссияNational Medical Research Center of Children’s HealthRussian Federation202430102024235295300Copyright © Мурашкин Н.Н., Материкин А.И., Епишев Р.В., Леонова М.А., Опрятин Л.А., Федоров Д.В., Иванов Р.А., Савелова А.А., Павлова Е.С., 20242024Мурашкин Н.Н., Материкин А.И., Епишев Р.В., Леонова М.А., Опрятин Л.А., Федоров Д.В., Иванов Р.А., Савелова А.А., Павлова Е.С.Murashkin N.N., Materikin A.I., Epishev R.V., Leonova M.A., Opryatin L.A., Fedorov D.V., Ivanov R.A., Savelov A.A., Pavlov E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/3597

Прогресс в понимании механизмов, лежащих в основе хронических воспалительных заболеваний кожи, таких как вульгарный псориаз, привел к появлению новых вариантов лечения, основной целью которых является облегчение симптомов. Кроме того, эти знания могут стать основой для новых стратегий достижения глубокой ремиссии или ремиссии без лечения, то есть модификации заболевания с потенциальным влиянием на сопутствующие состояния. Однако достижение этой цели требует дальнейшего изучения таких важных аспектов, как определение модификации заболевания и показателей активности болезни, дальнейшее понимание механизмов патогенеза, этиологии и системных побочных эффектов, окон потенциальных возможностей, биомаркеров для успешной стратификации пациентов и вмешательства, а также соответствующего дизайна исследования. Раннее вмешательство с использованием генно-инженерных биологических препаратов, таких как секукинумаб, представляет собой новый сдвиг парадигмы для улучшения результатов при иммуноопосредованных заболеваниях, необходимы доказательства для определения его полезности при псориазе. Высокий уровень устойчивого очищения кожи, наблюдаемый на фоне применения секукинумаба по сравнению со стандартным лечением и применением фототерапии, свидетельствует о потенциальной пользе раннего лечения биологическими препаратами для достижения полного очищения кожи и нормализации качества жизни, обучения и повседневной активности. Также это может служить обоснованием для изменения стратегии лечения пациентов с впервые выявленным умеренно тяжелым бляшечным псориазом. Ключевые слова: псориаз, дети, секукинумаб, болезнь-модифицирующая терапия.

Advances in understanding the mechanisms underlying chronic inflammatory skin diseases, such as psoriasis vulgaris, have led to implementation of new treatment options aimed at symptoms relieving. Moreover, this data may become the basis for new strategies to achieve sustained or treatment-free remission, that is disease modification with potential impact on comorbid conditions. However, achieving this goal requires further study of such crucial aspects as the terms of disease modification and disease activity indicators, deeper understanding of pathogenesis mechanisms, etiology, and systemic side effects, possible opportunities, biomarkers for successful patient stratification and intervention, as well as the adequate study design. Early intervention with genetically engineered biologic drugs such as secukinumab represents new paradigm shift in improvement of immune-mediated diseases outcomes. However, new evidence is needed to determine its efficacy in psoriasis. High level of sustained skin clearance observed on secukinumab therapy compared to standard treatment and phototherapy indicates the potential benefit of early biologic drugs treatment to achieve complete skin clearance and improvement in quality of life, education, and daily activities. It can also become a background for changing treatment strategies for patients with newly diagnosed moderate-to-severe plaque psoriasis. Keywords: psoriasis, children, secukinumab, disease-modifying treatment

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