Bjerke J R, Geiger J M
Department of Dermatology, University of Bergen, Norway.
Acta Derm Venereol Suppl (Stockh). 1989;146:206-7.
The efficacy and tolerability of acitretin (etretin) in severe psoriasis was compared with that of etretinate in a double-blind randomized study for 12 weeks. A total of 127 patients received acitretin and 41 received etretinate. The initial daily dose was 40 mg/day over 4 weeks and was subsequently adjusted according to individual response. From week 5-12 the mean daily dose was 42.9 mg of acitretin (0.58 mg/kg) versus 49.2 mg of etretinate (0.65 mg/kg). Acitretin gave a PASI score reduction from baseline of 70.5% and etretinate a reduction of 68.4% (mean values). Acitretin tended to give more discomfort than etretinate, particularly with regard to hair loss and peeling of palms and soles. The differences found between acitretin and etretinate may be related to higher maximum plasma concentrations of acitretin. The considerably shorter half-life of acitretin, gives it a great advantage over etretinate with regard to risk of teratogenicity after cessation of treatment.
在一项为期12周的双盲随机研究中，比较了阿维A（依曲替酸）和异维A酸治疗重度银屑病的疗效和耐受性。共有127例患者接受阿维A治疗，41例接受异维A酸治疗。初始每日剂量为40mg/天，持续4周，随后根据个体反应进行调整。从第5周到第12周，阿维A的平均每日剂量为42.9mg（0.58mg/kg），而异维A酸为49.2mg（0.65mg/kg）。阿维A使银屑病面积和严重程度指数（PASI）评分较基线降低70.5%，异维A酸降低68.4%（均值）。阿维A比异维A酸更容易引起不适，尤其是在脱发以及手掌和脚底脱皮方面。阿维A和异维A酸之间的差异可能与阿维A更高的最大血药浓度有关。阿维A的半衰期明显更短，在治疗停止后致畸风险方面比异维A酸具有很大优势。
