Altai State Medical University

Netakimab is a humanized anti-interleukin-17A monoclonal antibody, it has marketing approval for treatment of adult patients with moderate-tosevere plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. This paper provides the results of the first 12-week period of phase III BCD-085-16/PLANETA-KIDS clinical study.Objective. The aim of the BCD-085-16/PLANETA-KIDS is to evaluate netakimab efficacy and safety in pediatric patients 6+ years old with moderate-to-severe plaque psoriasis.Methods. BCD-085-16/PLANETA-KIDS (NCT06640517) is a randomized, double-blind, placebo-controlled phase III clinical study with open-label active-comparator arm (adalimumab). A total of 155 male and female patients aged from 6 to 18 years with confirmed moderate-to-severe plaque psoriasis were randomized to receive netakimab (n = 83), placebo (n = 35), or adalimumab (n = 37). Netakimab dosage was weight adjusted: for patients weighing 50 kg or more netakimab dose was 120 mg (two injections of 60 mg/ml each), for patients weighing less than 50 kg netakimab dose was 60 mg (one injection of 60 mg/ml). Patients in the Netakimab group received netakimab subcutaneously once per week for the first three weeks (induction) and once every 4 weeks thereafter (maintenance). Patients in the Placebo group received placebo in blinded manner like netakimab. Adalimumab was administered in open-label way in doses recommended by the product’s SmPC. In this study co-primary efficacy endpoints were the proportion of patients achieving PASI75 and sPGA0/1 at week 12.Results. Netakimab has shown superiority over placebo for both co-primary endpoints. The proportion of patients achieving PASI75 at week 12 was 89.2% in the Netakimab group and 14.3% in the Placebo group, odds ratio (OR) 59.0, 95% CI [16.5; 211.5] (p < 0.0001). The proportion of patients achieving sPGA0/1 at week 12 was 83.1% in the Netakimab group and 8.6% in the Placebo group, OR 54.9, 95% CI [14.6; 206.5] (p < 0.0001). The subgroup analysis has shown consistent netakimab superiority over placebo for both co-primary endpoints, regardless of age, body weight and psoriasis severity. Throughout the 12-week period netakimab has shown favorable safety profile comparable to that in the Placebo group.Conclusion. The results of the 12-week period in the BCD-085-16/PLANETA-KIDS study have shown high efficacy of netakimab compared with placebo with favorable safety profile in children aged 6 years and older and adolescents with moderate-to-severe plaque psoriasis.

This article examines issues related to the possibility of the presence of elements of Celtic culture and their carriers of in Scandinavia during the Roman Iron Age. It has been reviewed the ethnic affiliation of many northern tribes mentioned by ancient authors is highly controversial and requires that the processes of cultivation of Scandinavian tribes be taken into account in the course of trade contacts, migrations caused by military conflicts, as well as naturally induced negative changes in habitat and its depletion during economic development. One of the reasons for the Celtic trade expansions to northeastern Europe may have been the search for sources of amber, which was highly valued in international trade, served as an intertribal exchange commodity, and also held sacred and cult significance. Archaeological and historical-anthropological research data indicate a possible Celtic presence on the Scandinavian Peninsula in Rogaland. Celtic tribes assimilated by the Germanic tribes could have represented the population of the aforementioned region.

Young haemophilia patients with a high incidence of caries, hard tooth tissue lesions, and gingival inflammation are prone to fear of bleeding during individual oral hygiene. This reduces hygiene effectiveness and results in unsatisfactory oral status, necessitating the development of specialised hygiene products. Subject. Toothpaste containing a special dye to improve cleaning quality and components aimed at reducing bleeding and inflammation. Objective. To evaluate the clinical and laboratory effectiveness of a new toothpaste used within a comprehensive dental protocol and its impact on oral tissues in young haemophilia patients. Methodology. An open controlled study was conducted. Subjects were divided into two parallel groups using stratified randomisation and pairwise matching. The observation group included 18 haemophilia patients aged 18-35 years who used an improved toothpaste (patented formulation). The comparison group comprised 18 individuals of the same age and gender with the same diagnosis who received a standard protocol approved by the Russian Dental Association. Assessed parameters: OHI-S index, SBI index, PMA index, mixed saliva pH, secretion rate, and viscosity. Measurements were taken at baseline, after 3 and 6 months. Statistical processing used Statistica version 10.0. Results. By the third month, use of the improved toothpaste in young haemophilia patients was associated with positive dynamics of OHI-S, SBI, and PMA indices regardless of disease severity. Additionally, pH shifted toward physiological values, saliva secretion rate increased, and viscosity decreased. No such changes occurred in the comparison group. Conclusion. Inclusion of the improved toothpaste in a prophylactic and therapeutic protocol for haemophilia patients aged 18–35 years achieves satisfactory or good oral hygiene, significant reduction of gingival bleeding, and decreased inflammation severity. Normalisation of mixed saliva (pH stabilization, increased secretion rate, reduced viscosity) was also observed. The most pronounced positive dynamics were noted in patients with more severe disease, making this approach particularly relevant.

Objective : To evaluate the impact of the severity of community-acquired pneumonia (CAP) on the clinical and functional characteristics, course, and outcomes of acute coronary syndrome that developed in the context of CAP. Materials and methods . A retrospective observational study with a case-control design element was conducted on 90 patients with acute coronary syndrome (ACS) and a history of CAP. Results . Regression analysis models revealed that hypoxemia (SpO 2 <90%), fibrinogen, troponin T, hemoglobin, and blood platelet levels, in combination with pneumonia severity and serum C-reactive protein (CRP), significantly impact tricuspid regurgitant jet velocity (TRJV), explaining 83.5% of its variability. The risk of paroxysmal atrial fibrillation increased with higher TRJV, greater pneumonia severity, and diuretic use. Conclusion . In patients with ACS combined with CAP, the role of hypoxemia and biological markers of inflammation in the development of right ventricular heart failure and paroxysmal atrial fibrillation has been established.

Gonadotropin-releasing hormone (GnRH) medications are used to treat a wide range of reproductive disorders. GnRH regulates not only the maturation and growth of the gonads, but also the immune system and metabolism, thereby affecting non-reproductive, somatic tissues. GnRH affects the lungs, but research findings are limited and not generalized. The aim was to summarize the effects of GnRH on the lungs based on a literature review. Results . The presence of specific receptors for GnRH (GnRHR) in various lung cells and in the cells of some forms of cancer allows the use of GnRH-agonists and antagonists for the treatment of pulmonary disease and for both malignant tumors and their metastases to the lungs, especially those originating from the reproductive organs. The presence of GnRHR in tumor cells impels binding GnRH both to antitumor drugs for their targeted delivery and to magnetic nanoparticles for magnetic resonance imaging of cancer. Various forms of cytostatics conjugated with GnRH are less toxic and more effective than the cytostatics themselves. A large surface area with good vascularization and the ability to exchange various substances allow for systemic delivery of GnRH via inhalation into the lungs. Inhalation administration of anticancer drugs associated with a GnRH analogue is promising for the treatment of lung cancer with GnRHR expression. One of the pulmonary complications that develops when using both GnRH analogues and antagonists is interstitial lung disease, which can lead to death. An increased risk of classical pneumonia has been described after androgen deprivation therapy. Also, GnRH can enhance the development of lung pathology during radiation exposure. However, some publications report the absence of negative effects of GnRH on the pulmonary system in the experiments and in clinical practice and report that an increased level of GnRH even protects the lungs from edema and inflammatory damage, reduces the severity of sclerosis and fibrosis. Pulmonary macrophages, type 1 and 2 alveolar cells can be directly involved in the degradation of GnRH and have the necessary enzyme complexes. Conclusion . The obvious scarcity and inconsistency of publications on all aspects of GnRH action on the lungs indicates the need for further continuation of not only applied research, but also fundamental research, due to the high prospects. The GnRH drugs have advantages and disadvantages. Hormonal therapy should be prescribed with caution, taking into account all indications and contraindications, as well as the endocrinologist’s experience, aiming for the most favorable long-term result.