Acitretin, an active metabolite of etretinate, is the most widely used systemic retinoid in the treatment of psoriasis. There are several unique characteristics of this drug, which set it apart from other options in the therapeutic armamentarium of psoriasis. Learn more about Psoriasis: Recommendations for retinoids at aad.org. The oral retinoids are vitamin-A derivatives that have been used to treat psoriasis since the early 1980s. Etretinate was the first retinoid introduced for the treatment of severe psoriasis and replaced in 1988 by acitretin, the active metabolite of etretinate. Lowe NJ, Lazarus V,Matt L. Systemic retinoid therapy for psoriasis. Phototherapy, classic systemic treatments (methotrexate, acitretin, and ciclosporin), and biologic agents (etanercept, infliximab, adalimumab, and ustekinumab) constitute a broad therapeutic arsenal that increases the likelihood of achieving control of severe and extensive disease in patients with psoriasis. The introduction of etretinate, the first retinoid used to treat psoriasis, revolutionized psoriasis therapy, adding an interesting new option to the limited therapeutic arsenal available at that time for severe cases essentially methotrexate and psoralen-UV-A (PUVA) therapy. As a result, etretinate was replaced in 1997 by its active metabolite, acitretin, a drug with similar efficacy but a shorter half-life. One of the most common adverse effects of acitretin therapy, together with muscosal alterations, is an abnormal lipid profile.
SORIATANE must not be used by females who are pregnant, or who intend to become pregnant during therapy or at any time for at least 3 years following discontinuation of therapy. SORIATANE should be prescribed only by those who have special competence in the diagnosis and treatment of severe psoriasis, are experienced in the use of systemic retinoids, and understand the risk of teratogenicity. If the second pregnancy test is negative, initiation of treatment with SORIATANE should begin within 7 days of the specimen collection. Popular Collections. Acitretin, a synthetic retinoid, is the pharmacologically active metabolite of etretinate. In 1986, etretinate was approved for the treatment of psoriasis, but problems like long-term storage in fat led to its replacement with acitretin in 1998. It is metabolized mainly in the liver into 13-cisisoacitretin, which is excreted both in urine and feces. However, when used in combination with other topical and systemic therapies (topical corticosteroids, topical vitamin D preparations, psoralen with UVA (PUVA, ultraviolet B (UVB) therapy) it is as potent as classical therapies. A small amount of acitretin is converted into etretinate, which is more lipid-soluble and persists for much longer time in the fatty tissues. 5 This has created concern that birth defects might result if acitretin-treated women inadvertently ingest alcohol, which is commonly used in cough syrup, over-the-counter medications and cooking ingredients. Acitretin is absolutely contraindicated in the female patients who are pregnant or want to become pregnant in near future and relatively contraindicated in patients having significant systemic disease and severe lipid derangements.
Severe extensive psoriasis which is resistant to other forms of therapy. When Acitretin is used in combination with other types of therapy, it may be possible, depending on the individual patient’s response, to reduce the dosage of Acitretin. Acitretin should only be prescribed by physicians who are experienced in the use of systemic retinoids and understand the risk of teratogenicity associated with acitretin therapy (see Section 4. In patients with diabetes, alcoholism, obesity, cardiovascular risk factors or a lipid metabolism disorder undergoing treatment with acitretin, more frequent checks are necessary of serum values for lipids,and/or glycaemia and other cardiovascular risk indicators, e. Common (1/100 to 1/10). Introduction: Acitretin is a systemic retinoid drug used in the treatment of severe psoriasis. It is an active metabolite of the precursor drug, etretinate (Tegison, Hoffmann-La Roche, Nutley, NJ), which was widely used in the United States (U. NJ), which was widely used in the United States (U.S.) as a systemic psoriasis therapy until 1998 when it was withdrawn from the market and replaced by acitretin. Etretinate is 50 times more lipophilic than acitretin and is sequestered in fatty tissues, leading to a mean terminal half-life of 120 days. Summary: An oral retinoid used in the treatment of keratotic genodermatosis, lichen planus, and psoriasis. Clinical and laboratory features in acute generalized pustular psoriasis: a retrospective study of 34 patientsJo o Borges-CostaClinical University of Dermatology of Lisbon, PortugalAm J Clin Dermatol 12:271-6. Acitretin, an active metabolite of etretinate, is the most widely used systemic retinoid in the treatment of psoriasis.
Soriatane (acitretin) Drug Information: Description, User Reviews, Drug Side Effects, Interactions
Acitretin, a synthetic oral retinoid, has been used by dermatologists for over twenty years. Etretinate is an ethyl ester prodrug that is converted into the active metabolite acitretin.