Особенности применения генно-инженерной биологической терапии (устекинумаб) у детей с псориазом при наличии сопутствующего метаболического синдрома или неэффективности предшествующей биологической терапии: клинические наблюдения

Обоснование. Псориаз — хроническое иммуноопосредованное заболевание многофакторной природы, которое зачастую требует назначения генно-инженерных биологических препаратов. Назначение последних имеет ряд особенностей и рисков, а также зависит от множества факторов. Рассмотрены результаты применения устекинумаба в качестве препарата выбора при наличии сопутствующего метаболического синдрома у ребенка с синдромом Дауна, а также случая неэффективности предшествующей биологической терапии ингибиторами.

Описание клинических случаев. Представлено описание двух клинических случаев терапии с применением устекинумаба у детей с псориазом тяжелого течения. В первом случае рассмотрена ситуация выбора системной терапии у ребенка, страдающего синдромом Дауна и имеющего сложный коморбидный фон: ожирение и стеатогепатит. Второй случай интересен выбором тактики лечения у пациента с отягощенным по псориазу семейным анамнезом, длительно получающего метотрексат, а затем этанерцепт с последующей потерей эффективности и выраженным обострением заболевания на фоне отсутствия патогенетической терапии.

Заключение. Исходя из результатов исследований и рассмотренных клинических ситуаций, можно утверждать, что устекинумаб является предпочтительным биологическим препаратом для лечения детей с тяжелым течением псориаза, имеющих коморбидные патологии и нуждающихся в переключении биологического агента в связи с неэффективностью предшествующей терапии.

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