Borghi Alessandro, Corazza Monica, Bertoldi Alberto Maria, Caroppo Francesca, Virgili Annarosa
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Ferrara, Via Savonarola 9, I-44121 Ferrara, Italy.
Acta Derm Venereol. 2015 Mar;95(3):332-6. doi: 10.2340/00015555-1921.
The efficacy and safety of acitretin was evaluated retrospectively in a cohort of 46 patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index (PASI) range 10-42). Patients were treated at an initial dose of 10 mg/day acitretin, which was then gradually increased until the best therapeutic effect with the fewest adverse effects was reached (< 50 mg/day) and later decreased and maintained at the lowest effective dosage. Efficacy measures were: (i) PASI75 (75% improvement) and PASI50 between 10 and 16 weeks; and (ii) PASI75 even after 16 weeks of treatment. At weeks 10-16, PASI75 and PASI50 were achieved by 47.8% and 87% of the patients, respectively. Overall, 67.3% reached PASI75. Adverse events occurred in 18 patients (39.1%); among these, 4 (8.7%) discontinued acitretin. Our findings suggest that acitretin at an initial low, gradually escalating dose, and subsequently maintained at the minimal effective dose, is a suitable treatment option for plaque psoriasis as it provides clear-cut improvement in most treated patients while minimizing the risks of side-effects.
对46例中度至重度斑块状银屑病患者（银屑病面积和严重程度指数（PASI）范围为10 - 42）进行回顾性评估阿维A的疗效和安全性。患者初始剂量为阿维A 10毫克/天，然后逐渐增加剂量，直至达到最佳治疗效果且不良反应最少（<50毫克/天），随后减少剂量并维持在最低有效剂量。疗效指标为：（i）10至16周时的PASI75（改善75%）和PASI50；以及（ii）治疗16周后仍达到PASI75。在第10 - 16周时，分别有47.8%和87%的患者达到PASI75和PASI50。总体而言，67.3%的患者达到PASI75。18例患者（39.1%）出现不良事件；其中4例（8.7%）停用阿维A。我们的研究结果表明，初始低剂量、逐渐递增剂量并随后维持在最低有效剂量的阿维A是斑块状银屑病的合适治疗选择，因为它能使大多数接受治疗的患者明显改善，同时将副作用风险降至最低。
