Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA.
Am J Clin Dermatol. 2013 Feb;14(1):9-25. doi: 10.1007/s40257-012-0003-7.
Psoriasis is a chronic, systemic, inflammatory condition for which a variety of treatment modalities exist. Combinations of therapies are used often in clinical practice to enhance efficacy and reduce drug toxicities.
The purpose of this review is to assess the literature on the efficacy and safety of combination therapy in the treatment of psoriasis.
MEDLINE was reviewed to identify English-language publications from 1966 to 2011 examining combination therapy in psoriasis. Fifty-three articles met inclusion criteria and were included in this review. Randomized controlled trials addressing various combinations of treatment modalities for psoriasis were included. Data from these clinical studies were summarized and the outcomes were discussed.
Large-scale, randomized controlled trials investigating the use of various combination therapies in psoriasis are limited. The strongest data support the use of combinations of vitamin D derivatives and corticosteroids as topical combinations and, to a lesser extent, the combination of other topical agents. Phototherapy and topical vitamin D derivatives as well as phototherapy in combination with oral retinoids are well supported in the literature. Combinations of systemic medications, though often used clinically, have little data to support their efficacy or safety.
Our data were limited by the small number of clinical trials examining the multiple available combinations that are used in clinical practice.
The use of combination treatments falls within the standard of care for psoriasis, even if these combinations have not been extensively studied in clinical trials.
银屑病是一种慢性、全身性、炎症性疾病，有多种治疗方法。在临床实践中，经常使用联合治疗来提高疗效和降低药物毒性。
本综述旨在评估银屑病联合治疗的疗效和安全性的文献。
通过 MEDLINE 检索了 1966 年至 2011 年期间以英文发表的评估银屑病联合治疗的文献。53 篇文章符合纳入标准，并纳入本综述。纳入了评估各种治疗方法联合治疗银屑病的随机对照试验。总结了这些临床研究的数据，并讨论了结果。
大规模、随机对照试验调查了各种联合治疗方法在银屑病中的应用，其数据有限。最有力的数据支持维生素 D 衍生物和皮质类固醇类药物作为局部联合用药，以及在较小程度上支持其他局部药物联合应用。光疗和局部维生素 D 衍生物以及光疗联合口服类维甲酸在文献中得到了很好的支持。尽管在临床上经常使用联合治疗系统药物，但几乎没有数据支持其疗效或安全性。
我们的数据受到在临床实践中使用的多种联合治疗方案的临床试验数量较少的限制。
联合治疗的使用属于银屑病的标准治疗方法，即使这些联合治疗方案在临床试验中没有得到广泛研究。
