Ефективність застосування піоглітазону в комплексному лікуванні хворих на псоріаз із супутнім аліментарним ожирінням

Abstract

Relevance. Psoriasis is the common chronic genetically determined autoimmune polyetiological inflammatory disease with impaired epidermal proliferation, provoked by exogenous and endogenous factors, and manifested by erythematous and scaly elements, papules and plaques. Despite the significant prevalence of psoriasis and a large number of studies on this problem, there is still no single view on the pathogenesis of this dermatosis. To objectively understand the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Recently, an indisputable link between psoriasis and obesity has been proven. The scientific literature widely covers the issue of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and taking into account the role of proinflammatory nuclear transcription factors, thiazolidinediones are the pathogenetically justified drugs of choice for treatment of these diseases. The objective. To determine the effectiveness of the use of 45 mg of pioglitazone 1 time per day for 26 weeks in the complex treatment of patients with widespread psoriasis vulgaris of moderate severity with concomitant alimentary obesity of I–II degrees. Materials and research methods. Clinical and immunological studies of indicators of systemic inflammation. Results. the use of 45 mg pioglitazone for 26 weeks led to a decrease in systemic inflammation in terms of IL-33 by 83.7%, IL-6 by 72%, uch-CRP by 76.8% and the PASI index by 46.8% with repeated relapse diseases. Conclusions. Long-term use of 45 mg of pioglitazone in the complex treatment of patients with widespread psoriasis vulgaris of moderate severity with concomitant alimentary obesity of I–II degrees proved to be effective and contributed to a milder course of psoriasis with repeated relapse of the disease.