Vol 22, No 7 (2020)

Netakimab (NTK) is a humanized anti-interleukin-17А monoclonal antibody approved for the treatment of psoriatic arthritis (PsA), ankylosing spondylitis, moderate to severe plaque psoriasis. Aim. We aimed to evaluate the safety and efficacy of NTK in anti-TNF-naive PsA patients, using a subanalysis of 24-week results of the phase III PATERA study. Materials and methods. The core population of PATERA study included 194 patients with active PsA and an inadequate response to previous therapy with nonsteroidal anti-inflammatory drugs, conventional or biologic disease-modifying antirheumatic drugs, randomized in a 1:1 ratio to receive subcutaneous 120 mg NTK or placebo. Among them 155 patients, 75 in the NTK arm and 80 in the placebo arm, were anti-TNF-naive and complied with subanalysis inclusion criterion. Results. Subanalysis results are consistent with core population data. 82.7% of patients in the NTK arm and 11.3% of patients in the placebo arm achieved ACR20 at week 24 (p<0.0001). NTK led to significant decline in PsA activity, axial disease, skin manifestations. Treatment-related adverse events (AE) were observed in 14.7% of patients in the NTK arm, 8.8% in the placebo arm and were mainly presented with laboratory abnormalities (hypercholesterolemia, increased alanine aminotransferase), blood and lymphatic disorders (lymphopenia). Most of AEs were mild and moderate. Conclusions. NTK has a preferable safety profile and significantly declines the severity of PsA symptoms when used as the first bDMARD.

Review of L.P. Kotrehova speech

Review of N.S. Rudneva speech

Chronic pruritus still causes difficulties not only for patients, but also for physicians. Dermatological diseases are the major cause of itching, however the list of triggers causing pruritus is much longer. Thus, many chronic diseases can be accompanied by itching, which has its own features. In some liver disorders (cholangitis, viral hepatitis), generalized pruritus often develops. Uremic pruritus in chronic kidney disease occurs in 50% of dialysis patients. Patients with diabetes mellitus also sometimes experience chronic pruritus that gets worse at night. Neuropathic pruritus is often accompanied by other discomforts, such as numbness or mild pain. Also, it should not be ruled out that a drug can become the cause of itching. The reaction to the drug can occur immediately or be delayed. With such a wide list of underlying causes of pruritus, its diagnosis and therapy becomes a complex task and requires the participation of several specialists to select the optimal therapy.

The article contains a review of modern data on the etiology, pathogenesis and clinical manifestations of onychomycosis and onychodystrophies. The author describes the options for the successful treatment of onychomycosis and onychodystrophies, as well as further care of the nail plates after the completion of therapy. The options for the treatment of onychomycosis and onychodystrophies, further care of the nail plates after the completion of therapy are described. A skilful combination of topical agents of Mycostop®, Mykolept® and Clavio® (line of drugs) allows achieving the rehabilitation of patients with onychomycosis and onychodystrophies of various origins with reliable efficiency.

Foot mycosis is one of the most common skin diseases. Its prevalence in the general population ranges from 5 to 20%. The main causative agents of foot mycosis are dermatophytes; they account for 80-90% of cases. Terbinafine is an antifungal drug that belongs to the allylamine group, with a wide spectrum of antifungal activity. It has been registered since 1991 in Europe and is included in the WHO Model List of Essential Medicines. The article discusses the features of the use of various forms of terbinafine, depending on the clinical picture of foot mycosis. It presents Russian and foreign data on the efficacy and safety of terbinafine in the topical therapy of foot mycosis.

Diabetes mellitus (DM) is one of the most common chronic diseases, which occurs in about 6% of the population. Various skin changes in individuals with both type 1 and type 2 DM are quite common and can cause certain difficulties in diagnosis and choice of therapeutic tactics. Such patients may need the help of not only an endocrinologist, but also doctors of other specialties - a dermatologist, a surgeon, an allergist. The article presents data on the most common dermatological diseases associated with DM, identifies the main links of their pathogenesis, methods of diagnosis and differential diagnosis. It discusses the possibilities of using the ultrasound skin imaging for the diagnosis and differential diagnosis of one of the most common dermatoses in diabetes, necrobiosis lipoidica. It considers the features of therapy for dermatological diseases in patients with impaired carbohydrate metabolism.

Improving diagnostic capabilities leads to a significant increase in clinical situations, when it is already difficult to talk about the presence of a single disease in a patient - currently, in most clinical cases, there is a combined or concomitant pathology. The review considers the issues of acne comorbidity and disorders of intestinal microbiocenosis in theoretical and practical aspects. In 1930, the gastroenterological mechanism of the relationship between emotional and nervous conditions (anxiety, depression) and skin diseases (such as acne) was formulated and designated as the "gut-brain-skin axis". For several decades, this hypothesis was dormant. However, reviews of the last decade provide numerous facts that indirectly indicate the validity of the “intestine-brain-skin” hypothesis, and are the basis for the theoretical comorbidity of acne and intestinal microbiocenosis disorders. in real clinical practice, this relationship does not seem so obvious and requires further study of the mechanisms and effects of oral probiotics in acne.

Until the beginning of the ХХ century, syphilis was a fairly common disease, which found a bright, memorable reflection in the fiction of those times. This fact has played a great role in spreading knowledge about the consequences of this disease among the reading public, since special medical literature is available only to a small segment of the population, mainly armed with special education.