gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2019-29-5-13-20gastro-j-416Research ArticleОБЗОРЫREVIEWSНовые возможности терапии болезни КронаNew Possibilities for the Treatment of Crohn’s Diseasehttps://orcid.org/0000-0002-5673-7920МамиеваЗ. А.MamievaZ. A.

Мамиева Зарина Ахсарбековна — аспирант кафедры пропедевтики внутренних болезней

119991, г. Москва, ул. Погодинская, д. 1, стр.1.

Zarina A. Mamieva — Postgraduate Student, Propaedeutics of Internal Diseases Department

19991, Moscow, Pogodinskaya str., 1, building 1.

mamievazarina@mail.ruhttps://orcid.org/0000-0003-1312-120XПолуэктоваЕ. А.PoluektovaE. A.

Полуэктова Елена Александровна — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней

119991, г. Москва, ул. Погодинская, д. 1, стр.1.

Elena A. Poluektova* — Dr. Sci. (Med.), Prof., Propaedeutics of Internal Diseases Department

19991, Moscow, Pogodinskaya str., 1, building 1.

polouektova@rambler.ruhttps://orcid.org/0000-0001-8148-2862ШифринО. С.ShifrinO. S.

Шифрин Олег Самуилович  — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней

119991, г. Москва, ул. Погодинская, д. 1, стр.1.

Oleg S. Shifrin — Dr. Sci. (Med.), Prof., Propaedeutics of Internal Diseases Department

19991, Moscow, Pogodinskaya str., 1, building 1.

oleg_shifrin@mail.ruФГАОУ ВО «Первый Московский государственный университет им. И.М. Сеченова» (Сеченовский университет) Министерства здравоохранения Российской ФедерацииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation2019021220192951320Copyright © Мамиева З.А., Полуэктова Е.А., Шифрин О.С., 20192019Мамиева З.А., Полуэктова Е.А., Шифрин О.С.Mamieva Z.A., Poluektova E.A., Shifrin O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/416Цель обзора

Цель обзора: представить данные об эффективности и безопасности применения устекинумаба у пациентов с болезнью Крона.

Основные положения

Основные положения. Устекинумаб представляет собой полностью человеческое моноклональное антитело класса IgG1k к p40 субъединице ИЛ-12 и ИЛ-23. Блокируя взаимодействие субъединицы p40 c цепью IL-12Rβ1 на поверхности T-лимфоцитов и NK-клеток, препарат прерывает каскад гуморальных и клеточных реакций, приводящий к трансмуральному воспалению кишечной стенки. В ряде плацебо-контролируемых исследований продемонстрирована эффективность устекинумаба в индукции и поддержании ремиссии у пациентов с болезнью Крона, не ответивших на стандартную терапию (глюкокортикостероиды и иммуносупрессоры) и терапию антагонистами ФНО-α. Кроме того, была показана эффективность устекинумаба в поддержании клинического ответа и клинической ремиссии в течение двух лет терапии. Препарат обладает благоприятным профилем безопасности и низкой иммуногенностью.

Заключение

Заключение: в представленных исследованиях продемонстрировано, что устекинумаб является эффективным и безопасным препаратом для индукции и поддержания клинической ремиссии у пациентов с болезнью Крона.

Aim

Aim. To review data on the efficiency and safety of using Ustekinumab in patients with Crohn’s disease.

Key findings

Key findings. Ustekinumab is a fully human monoclonal antibody of the IgG1k class to the p40 subunit of IL-12 and IL-23. The drug interrupts the cascade of humoral and cellular reactions leading to transmural inflammation of the intestinal wall by blocking the interaction of the p40 subunit with the IL-12Rβ1 chain on the surface of T-lymphocytes and NK cells. A number of placebo-controlled studies have demonstrated the effectiveness of Ustekinumab in the induction and the maintenance of remission in those patients with Crohn’s disease who showed no response to conventional therapy (glucocorticosteroids and immunosuppressants) and therapy with TNF-α antagonists. In addition, the efficiency of Ustekinumab in maintaining a clinical response and clinical remission over two years of therapy has been shown. The drug has a favourable safety profile and a low immunogenicity.

Conclusion

Conclusion. The reviewed studies show Ustekinumab to be an effective and safe drug for the induction and the maintenance of clinical remission in patients with Crohn’s disease.

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The authors declare that there are no conflicts of interest present.