Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis. Since in psoriasis vulgaris retinoids are used predominantly in combination regimens, we investigated the therapeutic efficacy of acitretin and UV-B compared with placebo and UV-B in a double-blind, randomized multicenter trial in 82 patients with severe psoriasis. Treatment of psoriasis with acitretin in concert with UVB or PUVA is emerging as a viable clinical strategy. Compared with either acitretin or UV light monotherapy alone, the combination regimen enhances efficacy and limits treatment frequency, duration, and cumulative doses. Drawing from an extensive literature search and the expertise of its participants, this consensus conference advances clinical recommendations as well as clinical pearls for health providers who treat patients with chronic, moderate to severe plaque psoriasis and suggests avenues for future research. Despite the documented efficacy of topical corticosteroids as monotherapy in psoriasis, the addition of topical corticosteroids does not produce added benefit when studied in combination with UVB when compared with UVB monotherapy.
Treatment of psoriasis with acitretin in concert with UVB or PUVA is emerging as a viable clinical strategy. Compared with either acitretin or UV light monotherapy alone, the combination regimen enhances efficacy and limits treatment frequency, duration, and cumulative doses. The combination of acitretin with UVB or PUVA therapy is more effective than either phototherapy or acitretin alone. Efficacy of low-dose acitretin in the treatment of psoriasis. A 12-month treatment of severe psoriasis with acitretin: Results of a Canadian open multicentre trial. Efficacy of Acitretin and Commercial Tanning Bed Therapy for Psoriasis FREE. 10 A prospective study involving 20 patients with moderate to severe psoriasis treated with commercial tanning beds for 6 weeks showed that 80 of patients had a clinical improvement in the Psoriasis Area and Severity Index (PASI) score.
Consensus conference: acitretin in combination with UVB or PUVA in the treatment of psoriasis. Acitretin fulfills a unique role in the strategies used to treat psoriasis because its mechanism of action is different from that of other systemic drugs. Acitretin continues to be useful as monotherapy and in combination with other systemic treatments or phototherapy, and its role as a rescue drug or in combination with biologic agents is particularly interesting, as has been shown by recent reviews on this topic. The efficacy of acitretin, and most of its adverse effects, are dose-dependent and vary considerably from patient to patient. There is ample evidence of efficacy of the newer systemic therapies ( biologics ); however, cost is a major consideration with these agents. Patients with less acute disease can be treated with acitretin or methotrexate as first-line agents. Acitretin can be used in combination with UVB or PUVA therapy.
Consensus Conference: Acitretin In Combination With Uvb Or Puva In The Treatment Of Psoriasis
Studies comparing acitretin in combination with UVB versus UVB alone found better outcomes and sparing of UVB with acitretin-UVB in combination than with UVB alone. A RCT showed similar efficacy from the combination regimen of acitretin 0.4 mg/kg daily and etanercept 25 mg once weekly to that observed with etanercept 25 mg twice weekly thus proving etanercept-sparing effect of acitretin. 24 The combination of methotrexate and acitretin has been used in patients with severe psoriasis, where all other treatments have failed. In extensive clinical trials, acitretin has been shown to be effective in treating severe psoriasis both as monotherapy and in combination with other therapies. Combining therapy with PUVA or UVB increases efficacy and limits treatment frequencies, duration and cumulative doses. The efficacy of CsA in plaque psoriasis has been evidenced by several randomized studies, which also showed the dosage-dependent therapeutic effects, using the drug at dosages ranging from 1. Tar is often used in combination with other drugs and with ultraviolet B (UVB) phototherapy. Psoriasis treatments can be divided into three main types: topical treatments, light therapy and systemic medications. To minimize side effects and to increase effectiveness, topical corticosteroids are generally used on active outbreaks until they’re under control. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication. Moderate-to-Severe Psoriasis that has Failed to Respond to all Currently Approved Therapies for Psoriasis (all TNF Inhibitors, T-Cell Inhibiting Agents, and Acitretin) in Patients who Cannot Receive (a) Methotrexate, due to Excessive ( 10 Drinks per Week) Alcohol Use; and (b) Cyclosporine, due to Either Unmanageable Hypertension or Significantly Reduced Kidney Function. Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis.
Acitretin In Dermatology Sarkar R, Chugh S, Garg Vk
FDA-approved treatments for moderate to severe psoriasis, which affects approximately 33 of psoriasis patients,2 have burgeoned since 2003, when only acitretin, cyclosporine, methotrexate, and phototherapy were available. UVB received 2.5 times weekly for 8 weeks and twice weekly thereafter (108 administrations per year). Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser, Combination therapies are often more effective than one treatment alone. Tar is often used in combination with other drugs and with ultraviolet B (UVB) phototherapy. Evaluation of the efficacy of acitretin therapy for nail psoriasis. Severity of psoriasis was classified as mild, moderate, or severe. Observations from animal models of psoriasis and treatment with T cell specific inhibitors, such as ciclosporin, point to T cells as the driving force in inducing and maintaining the phenotypic changes seen in psoriasis. Acitretin is an oral retinoid approved for the treatment of psoriasis. Methotrexate has also been used in combination with UVB and PUVA. Adalimumab efficacy and safety in patients with moderate to severe chronic plaque psoriasis: Preliminary findings from a 12-week dose-ranging trial.