Oleh Admin Kalbe Medical pada May 18, 2017 07:30

Efektivitas Risankizumab untuk Psoriasis Sedang Berat

Psoriasis adalah penyakit autoimun sistemik yang ditandai oleh bercak dan plak berwarna kemerahan dan tebal pada sebagain atau seluruh tubuh. Gejala kulit mungkin adalah yang pertama disadari oleh pasien, namun selain gejala kulit juga ada beberapa gejala lainnya seperti psoriatic arthitis, yaitu gangguan pada sendi pasien, konjungtivitis, dan pasien psoriasis juga lebih rentan untuk mengalami berbagai penyakit seperti penyakit jantung, hipertensi, gangguan ginjal, dan penurunan kualitas hidup.

Patogenesis dari gejala kulit pada pasien psoriasis adalah karena adanya mekanisme autoimun beberapa jenis interleukin yang menyerang epidermis pada pasien psoriasis mengakibatkan proliferasi yang berlebihan dari epidermis berakibat pada terbentuknya plak. Salah satu dari beberapa jenis interleukin tersebut adalah interleukin 23. Ustekinumab adalah monoclonal antibody yang bekerja menghambat reseptor interleukin 12 dan interleukin 23. Karena juga menghambat interleukin 23, maka ustekinumab telah dibuktikan dapat bermanfaat untuk meringankan gejala psoriasis.


Akan tetapi baru-baru ini, terdapat sebuah monoclonal antibody yang baru yaitu risankizumab,  yang bekerja spesifik menghambat reseptor interleukin 23. Karena bekerja spesifik pada reseptor interleukin 23, maka risankizumab diduga memiliki aktivitas yang sebanding atau mungkin lebih baik dari ustekinumab. Untuk mengetahuinya maka dr. Papp dan tim dari Eropa dan Amerika Serikat melakukan sebuah uji klinik yang diterbitkan di jurnal Lancet tahun 2017.


Pada uji klinik ini, sebanyak 166 pasien dengan psoriasis sedang – berat diacak untuk mendapatkan risankizumab atau ustekinumab. Setelah 12 minggu kemudian dievaluasi gejala dan tanda psoriasisnya. Hasilnya adalah setelah 12 minggu, didapatkan bahwa: persentase pasien yang mencapai perbaikan skor PASI 90% mencapai 77% pada kelompok risankizumab dan 40% pada kelompok ustekinumab (P<0.001).


Kesimpulan:
Uji klinik ini menyimpulkan bahwa pada pasien psoriasis sedang dan berat, risankizumab secara bermakna lebih efektif untuk mengurangi lesi psoriasis dibandingkan dengan ustekinumab. (NNO)

Image : Ilustrasi
Referensi:
1.Psoriasis: Practice essentials, background, pathophysiology [Internet]. 2017 Apr 18 [cited 2017 Apr 29]. Available from: http://emedicine.medscape.com/article/1943419-overview
2.Papp KA, Blauvelt A, Bukhalo M, Gooderham M, Krueger JG, Lacour JP, et al. Risankizumab versus ustekinumab for moderate-to-severe plaque psoriasis. N Engl J Med. 2017 20;376(16):1551–60.

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