The effectiveness of the IL-17A inhibitor in generalized pustular psoriasis: a clinical case

Abstract

The first clinical case of the effective use of a domestic biological drug inhibitor netakimab ― IL-17A ― in a patient with persistently progressive, torpid to therapy generalized pustular psoriasis Tsumbush is presented. This rare systemic dermatosis refers to severe forms of psoriasis that threaten the patients life and require intensive therapy from the very first hours of the manifestation of the disease. The development of pustular psoriasis can be promoted by: long-term therapy with systemic glucocorticosteroids, cytostatics, oral contraceptives, as well as prolonged use of irritating external agents. In some cases, the disease is associated with high emotional stress, stress. In severe generalized pustular psoriasis, biological drugs, cyclosporine, methotrexate, and acitretin are effective.
 The article presents summary data on the effectiveness of first- and second-line drugs in the treatment of pustular psoriasis. According to the literature, patients with severe pustular psoriasis, torpid to standard therapy, demonstrate a positive response to treatment with biological drugs in most cases. Anti-TNF- are the most available biological drugs for the treatment of pustular psoriasis, and anti-IL-12/23 and anti-IL-17A can be considered as the first or second line of therapy for moderate-severe and refractory pustular psoriasis.
 The choice of effective therapy for the treatment of pustular psoriasis is an urgent problem of modern dermatology and the presented clinical case demonstrates the effectiveness and pronounced positive therapeutic effect of the IL-17A inhibitor for 1 day in the treatment of generalized pustular psoriasis resistant to previously conducted therapy, which allows us to count on the prospect of further successful use of this targeted drug in the treatment of severe pustular psoriasis.