Biološki lijekovi u liječenju vulgarne psorijaze

master's thesis

• Title (english): Biologic agents in treatment of vulgar psoriasis
• Author: Marija Omazić
• Mentor: Romana Čeović (mentor)
• Committee member: Branka Marinović (predsjednik povjerenstva)
• Committee member: Krešimir Kostović (član povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Vulgarna psorijaza je najčešći oblik psorijaze, kronične bolesti kože koja zahvaća 1-3% svjetske populacije. Psorijaza značajno utječe na kvalitetu života oboljelih. Uz lokalne pripravke u liječenju psorijaze primjenjuju se fototerapija i sustavna terapija. U liječenju srednje teških do teških oblika psorijaze danas se primjenjuje konvencionalna sustavna i biološka terapija. Liječenje se uvijek počinje konvencionalnom sustavnom terapijom koja prema sadašnjim smjernicama za liječenje psorijaze uključuje fotokemoterapiju, retinoide, metotreksat i ciklosporin. Kod bolesnika kod kojih konvencionalna sustavna terapija ne pokazuje zadovoljavajući terapijski učinak ili je kontraindicirana, može se primijeniti biološka terapija. Biološki lijekovi su lijekovi sintetizirani rekombinantnom DNA tehnologijom, a djeluju na specifične molekularne ciljeve. Biološki lijekovi su relativno novi lijekovi u liječenju psorijaze sa desetogodišnjim iskustvom primjene. Razumijevanje djelovanja bioloških lijekova i njihovih nuspojava od velike je važnosti za liječnike te se stoga probir pacijenata kod kojih se planira uvesti ova terapija mora provesti oprezno i u skladu sa smjernicama. U trenutku pisanja ovog rada u Republici Hrvatskoj za liječenje vulgarne psorijaze registrirane su dvije skupine bioloških lijekova - antagonisti TNF-α (adalimumab, infliksimab i etanercept) te antagonist IL12/23 (ustekinumab). Pri njihovoj primjeni obvezan je redoviti nadzor dermatologa, praćenje laboratorijskih nalaza i stupnja eventualnog poboljšanja kožnih lezija pomoću PASI zbroja i indeksa kvalitete života. U tijeku su brojna istraživanja u liječenju vulgarne psorijaze biološkim lijekovima.

Abstract (english)

Vulgar psoriasis is the most common type of psoriasis, chronic skin disease which affects 1-3% of the world population. Psoriasis significantly affects the quality of life of a patient. Besides local preparations, in treatment of psoriasis phototherapy and systemic therapy are used. In treatment of moderate-to-severe psoriasis, conventional systemic therapy and biologic therapy are used today. Treatment always starts with conventional systemic therapy which, according to current guidelines for the treatment of psoriasis, includes photochemotherapy, retinoids, methotrexate and cyclosporine. In patients that do not achieve satisfying therapeutic effect with conventional systemic treatment, or they have a contraindication, biological therapy may be used. Biological agents are drugs synthesized by recombinant DNA technology and they act on specific molecular targets. Biological agents are relatively new drugs, with 10-year experience of use. Understanding the mechanisms of action of biological agents and their adverse events is very important for medical doctors and because of that screening of the patients that are considered to undergo biological therapy must be done with caution and in accordance with the guidelines. At the time of writing this thesis, two categories of biological agents are registered for the treatment of vulgar psoriasis in Croatia - TNF-α antagonists (adalimumab, infliximab and etanercept) and IL12/23 antagonists (ustekinumab). When these are used, regular supervision of dermatologist, laboratory tests and assessment of level of possible skin improvements by PASI index and Quality of Life index must be done. Numerous trials in progress are studying the treatment of vulgar psoriasis by biological agents.

• Keywords: vulgarna psorijaza; biološki lijekovi; adalimumab; infliksimab; etanercept; ustekinumab
• Keywords (english): vulgar psoriasis; biological agents; adalimumab; infliximab; etanercept; ustekinumab
• Language: croatian
• URN:NBN: urn:nbn:hr:105:913982
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-08 08:32:15