阿维 A 酯治疗银屑病的研究进展。

A review of acitretin for the treatment of psoriasis.

机构信息

University of California Davis Medical Center, Department of Dermatology, Sacramento, 95816, USA.

出版信息

Expert Opin Drug Saf. 2009 Nov;8(6):769-79. doi: 10.1517/14740330903393732.

DOI:10.1517/14740330903393732

PMID:19998529

Abstract

BACKGROUND

Acitretin is an oral retinoid that is approved for the treatment of psoriasis. It is unique compared to other systemic therapies for psoriasis such as methotrexate and cyclosporine in that it is not immunosuppressive. It is, therefore, safe for use in psoriasis patients with a history of chronic infection such as HIV, hepatitis B, hepatitis C or malignancy who have a contraindication to systemic immunosuppressive therapy and require systemic therapy because topical therapy is inadequate and they are unable to commit to phototherapy. Acitretin is one of the treatments of choice for pustular psoriasis. Even though acitretin is less effective as a monotherapy for chronic plaque psoriasis, combination therapy with other agents, especially UVB or psoralen plus UVA phototherapy, can enhance efficacy.

OBJECTIVE

To provide an updated review of the safety and efficacy of acitretin in the treatment for psoriasis.

METHODS

Literature review of journal articles from 2008 to 2009 since the last review of acitretin evaluated medical literature from 2005 to 2008.

RESULTS/CONCLUSION: Acitretin is an effective systemic therapy for psoriasis and is generally well tolerated at low doses for long-term use. If monotherapy with acitretin is inadequate, it can be used in combination with other treatments, particularly UVB phototherapy, to increase efficacy.

摘要

背景

阿维 A 酯是一种口服维 A 酸类药物，被批准用于治疗银屑病。与甲氨蝶呤和环孢素等其他治疗银屑病的系统性药物相比，它具有独特之处，因为它没有免疫抑制作用。因此，对于患有慢性感染（如 HIV、乙型肝炎、丙型肝炎或恶性肿瘤）且对系统性免疫抑制治疗有禁忌症、需要系统性治疗的银屑病患者，因其无法进行光疗且局部治疗效果不佳，阿维 A 酯是安全的选择。阿维 A 酯是脓疱性银屑病的治疗选择之一。尽管阿维 A 酯作为慢性斑块状银屑病的单一疗法效果较差，但与其他药物联合治疗，特别是与 UVB 或补骨脂素加 UVA 光疗联合治疗，可提高疗效。