van de Kerkhof Peter
Department of Dermatology, University Hospital, Nijmegen, Netherlands.
Cutis. 2002 Nov;70(5 Suppl):16-20.
The most frequently used systemic treatments for severe psoriasis are methotrexate (MTX), oral retinoids, and cyclosporine; however, all of these agents are associated with dose-related toxicities that limit their use. The safety and efficacy of topical calcipotriene for the treatment of psoriasis have been demonstrated in numerous clinical studies. The rationale for using calcipotriene in combination with systemic therapies is based on their different modes of action and nonoverlapping side effects. Three controlled clinical trials have demonstrated that the addition of calcipotriene ointment to systemic antipsoriatic treatment with MTX, acitretin, and cyclosporine increases the therapeutic efficacy compared with systemic therapy alone and minimizes side effects by either reducing the dosage or duration of treatment.
治疗重度银屑病最常用的全身治疗药物是甲氨蝶呤（MTX）、口服维甲酸和环孢素；然而，所有这些药物都与剂量相关的毒性有关，这限制了它们的使用。在众多临床研究中已证实外用卡泊三烯治疗银屑病的安全性和有效性。将卡泊三烯与全身治疗联合使用的基本原理是基于它们不同的作用方式和不重叠的副作用。三项对照临床试验表明，在使用MTX、阿维A和环孢素进行全身抗银屑病治疗时添加卡泊三烯软膏，与单独进行全身治疗相比，可提高治疗效果，并通过减少治疗剂量或疗程将副作用降至最低。
