Biološka terapija i male molekule u liječenju umjerene do teške plak psorijaze

master's thesis

• Title (english): Biological therapy and small molecules in the treatment of moderate to severe plaque psoriasis
• Author: Leonarda Jagodić
• Mentor: Petra Turčić (mentor)
• Committee member: Petra Turčić (predsjednik povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Committee member: Živka Juričić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2022-05-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Psorijaza je kompleksna, imunološki posredovana upalna bolest koja se javlja u genetski podložnih
pojedinaca, a globalno pogađa približno 2,2% populacije. Tipično se manifestira na koži i
zglobovima no također se povezuje s brojnim komorbiditetnim bolestima ostavljajući negativne
posljedice na kvalitetu života bolesnika, posebice onih s umjerenim do teškim oblikom. S obzirom
na prisustvo komorbiditeta, nuspojave liječenja, različite preferencije te često neadherenciju
pacijenata, liječenje psorijaze još uvijek predstavlja veliki izazov. U većini slučajeva, terapija
uključuje primjenu lokalnih sredstava, fototerapije ili konvencionalnih sistemskih lijekova no
napredak u razumijevanju patofiziologije psorijaze doveo je do razvoja novih, visoko učinkovitih
ciljanih tretmana. Biološki lijekove i male sintetske molekule revolucionirale su liječenje psorijaze
zahvaljujući izvrsnoj djelotvornosti, povoljnom sigurnosnom profilu te poboljšanoj adherenciji
pacijenata. Iako ne pokazuju učinkovitost bioloških lijekova, male molekule posjeduju određene
prednosti poput peroralne i topikalne primjene, manjeg rizika od teških nuspojava te povoljnije
cijene. U biološke lijekove i male molekule odobrene za liječenje plak psorijaze ubrajaju se:
antagonisti TNF-α, inhibitori IL-17, inhibitori IL-12 i IL-23, inhibitori IL-23, inhibitor PDE-4
(apremilast) te ester fumaratne kiseline (dimetil fumarat). Brojni drugi biološki lijekovi i male
molekule koje su trenutno u fazama razvoja pokazuju obećavajuću učinkovitost te potencijal da
postanu sigurnije alternative trenutno dostupnih terapija.

Abstract (english)

Psoriasis is a complex, immune-mediated inflammatory disease that occurs in genetically
susceptible individuals and affects approximately 2.2% of the world's population. It typically
manifests on the skin and joints but is also associated with a number of comorbid diseases leaving
negative consequences on the quality of life of patients, especially those with moderate to severe
form. Given the presence of comorbidities, treatment side effects, different patient preferences and
frequent noncompliance, treating psoriasis remains a major challenge. In most cases, treatment
involves the use of topical agents, phototherapy and conventional systemic medications but advances
in understanding the pathophysiology of psoriasis have led to the development of new highly
effective targeted treatments. Biologics and small synthetic molecules have revolutionized the
treatment of psoriasis thanks to their excellent efficacy, favorable safety profile and improved patient
adherence. Although they do not show the effectiveness of biologics, small molecules have certain
advantages such as oral and topical administration, lower risk of severe side effects and more
favorable price. Biologics and small molecules approved for the treatment of plaque psoriasis
include: TNF-α antagonists, IL-17 inhibitors, IL-12 and IL-23 inhibitors, IL-23 inhibitors, PDE-4
inhibitor (apremilast) and fumaric acid ester (dimethyl fumarate). Numerous other biologics and
small molecules currently under development show promising efficacy and the potential to become
safer alternatives to currently available therapies.

• Keywords: psorijaza; patogeneza; konvencionalna sistemska terapija; biološka terapija; male molekule
• Keywords (english): psoriasis; pathogenesis; conventional systemic therapy; biological therapy; small molecules
• Language: croatian
• URN:NBN: urn:nbn:hr:163:577214
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-05-27 09:10:17