AB0768 TREATMENT WITH TOFACITINIB IN REFRACTORY PSORIATIC ARTHRITIS. MULTICENTER STUDY OF 87 PATIENTS IN CLINICAL PRACTICE

Objectives: increasing the sorption capacity of medications based on interleukin-12 and interleukin-23 in patients with psoriatic arthritis Methods: To reduce the concentration of anti-inflammatory cytokines (IL-12, IL-23) we ran the blood from psoriatic arthritis patients through granules which had been obtained preliminarily by emulsion polymerization. Antibodies to IL-12 and IL-23 were obtained from the commercial formulation Ustekinumab with a concentration of monoclonal antibodies -0,2 mg in 1 ml of saline solution. They were of spherical shape, with gel particle size 10 – 100 mcm. Specific sorption capacity of magnetocontrollable polyacrylamide granules (MPG) was determined using a mini-column with working chamber capacity of 0,2 ml, filled with MPG through which Il-12 and Il-23 solutions (1 ml) were run in increasing concentrations. Results: Perfusion of the blood through a magnetocontrollable adsorbent was done using a column of 10 ml capacity equipped with an electric magnet; magnetocontrollable polyacrylamide granules with immobilized antibodies to IL-12 and IL-23 were added to the column. This device was used for in vitro processing of heparinized blood from 10 patients with psoriatic arthritis of varying degree of activity who had not received parenteral administration of cytokine IL-12 and IL-23 inhibitors (Ustekinumab) for 12 months. Blood from 10 apparently healthy donors was used as control; the perfusion procedure was the same. The concentration of cytokines (IL-12 and IL-23) in the blood plasma was determined with immunoenzyme assay commercial kits: Bender Med. Systems, USA for IL-12, and Bender Med. Systems, Vienna Austria for IL-23. The parameters under study were determined twice for each sample: prior to and after perfusion. It was established that perfusion through a magnetocontrollable adsorbent leads to a considerable decrease in IL-12: by 99,8% from baseline (in apparently healthy individuals), and by 99,9% in psoriatic arthritis patients; the concentration of IL-23 decreased by 99,9% in psoriatic arthritis patients. That is why decreasing the cytokine level as much as possible is of great practical importance as the cytokines play the leading role in psoriatic arthritis pathogenesis. When comparing data on carbon–based adsorbents found in literature we saw that the cytokine concentration decreased by 92,64% from baseline. Elimination of the cytokines did not bring about any statistically important change in the content of blood corpuscles, which is an additional advantage of the method. Conclusion: The obtained findings demonstrate high effectiveness of the method of simultaneous sorption of interleukin-12 and interleukin-23 using an original magnetocontrollable adsorbent based on Ustekinumab. The proposed adsorbent shows little traumatism in relation to blood corpuscles, as well as low nonspecific sorption. Extracorporeal elimination of cytokines from the blood flow can be a promising preparatory step in genetically designed treatment of patients with psoriatic arthritis. Disclosure of Interests: None declared