a Department of Dermatology, Center for Dermatology Research , Wake Forest School of Medicine , Winston-Salem , NC , USA.
b Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
Expert Opin Drug Metab Toxicol. 2018 Sep;14(9):919-927. doi: 10.1080/17425255.2018.1515198. Epub 2018 Sep 3.
Psoriasis is a prevalent cutaneous condition with severe physical and psychological manifestations. Since the advent of biologics, clinical outcomes in psoriasis have improved. However, retinoids are useful in the correct clinical context. Tazarotene and acitretin are currently the only US Food and Drug Administration approved retinoids for treatment of psoriasis. Both topical tazarotene and oral acitretin act on retinoic acid receptors and retinoid-X-receptors, resulting in altered gene expression of inflammatory cytokines and inhibition of keratinocyte proliferation. Areas covered: This article provides an in-depth pharmacologic and clinical review on the use of tazarotene and acitretin in psoriasis. The PubMed database was searched using combinations of keywords: acitretin, bioavailability, dosing, efficacy, etretinate, interactions, mechanism, pharmacodynamics, pharmacokinetics, pharmacogenetics, psoriasis, safety, tazarotene, tolerability, and toxicity. Expert opinion: Tazarotene and acitretin are effective treatments for psoriasis. Benefits include lack of immunosuppression and success treating inflammatory psoriasis. When combined with other topical and systemic agents, both retinoids improve clinical efficacy while lowering the treatment threshold. However, topical adherence and bothersome side effects can limit retinoid use. Acitretin and tazarotene both improve outcomes through a unique mechanism that especially benefits subsets of patients, despite side effects and limitations.
银屑病是一种常见的皮肤疾病，具有严重的生理和心理表现。自从生物制剂问世以来，银屑病的临床疗效得到了改善。然而，维 A 酸类药物在正确的临床环境中是有用的。他扎罗汀和阿维 A 酯是目前唯一获得美国食品和药物管理局批准用于治疗银屑病的维 A 酸类药物。局部用他扎罗汀和口服阿维 A 酯都作用于维 A 酸受体和维 A 酸-X 受体，导致炎症细胞因子的基因表达改变和角质形成细胞增殖抑制。涵盖领域：本文对他扎罗汀和阿维 A 酯在银屑病中的应用进行了深入的药理学和临床评价。使用关键词的组合在 PubMed 数据库中进行了检索：阿维 A 酯、生物利用度、剂量、疗效、依曲替酯、相互作用、机制、药效学、药代动力学、药物遗传学、银屑病、安全性、他扎罗汀、耐受性和毒性。专家意见：他扎罗汀和阿维 A 酯是治疗银屑病的有效药物。其益处包括无免疫抑制作用和成功治疗炎症性银屑病。当与其他局部和全身药物联合使用时，这两种维 A 酸类药物都能提高临床疗效，同时降低治疗阈值。然而，局部用药的依从性和令人烦恼的副作用可能会限制维 A 酸类药物的使用。尽管存在副作用和局限性，但他扎罗汀和阿维 A 酯都通过独特的机制改善了结果，这对某些患者亚群特别有益。
