Seppälä J, Laulainen M, Reunala T
Department of Rheumatology and Dermatology, University Central Hospital, Tampere, Finland.
Clin Rheumatol. 1988 Dec;7(4):498-503.
Etretinate is a synthetic vitamin A derivate given orally for the treatment of severe skin psoriasis. This drug has been reported to be effective also in psoriatic arthropathy and in this study we compared the efficacy and side-effects of etretinate with those of parenteral gold. Sixteen out of 18 patients completed 6 months of therapy with etretinate (initial dose 0.7 mg/kg/day) whereas only 7/9 patients completed 6 months of therapy with parenteral gold. A statistically significant decrease in the joint index occurred in both groups. In the etretinate group, the musculoskeletal symptoms improved considerably in 12 (67%) patients completing the treatment, and at the end of therapy also the skin lesions had healed or improved markedly in most patients. In two patients the reasons for terminating etretinate treatment were hypertriglyceridaemia and epigastric pain. In the gold group, seven patients could not complete the treatment regimen due to the common toxic side-effects of gold. The results of this study confirm that both etretinate and parenteral gold are effective in treating psoriatic arthropathy, and show that etretinate treatment seems to cause fewer harmful side-effects than chrysotherapy with parenteral gold.
依曲替酯是一种口服的合成维生素A衍生物，用于治疗严重的皮肤银屑病。据报道，这种药物对银屑病关节炎也有效。在本研究中，我们比较了依曲替酯与胃肠外金制剂的疗效和副作用。18例患者中有16例完成了6个月的依曲替酯治疗（初始剂量0.7mg/kg/天），而9例接受胃肠外金制剂治疗的患者中只有7例完成了6个月的治疗。两组的关节指数均出现了统计学上的显著下降。在依曲替酯组，完成治疗的12例（67%）患者的肌肉骨骼症状有显著改善，并且在治疗结束时，大多数患者的皮肤病变已经愈合或明显改善。有2例患者因高甘油三酯血症和上腹部疼痛而终止依曲替酯治疗。在金制剂组，7例患者因金制剂常见的毒性副作用而未能完成治疗方案。本研究结果证实，依曲替酯和胃肠外金制剂在治疗银屑病关节炎方面均有效，并且表明依曲替酯治疗似乎比胃肠外金制剂的金疗法产生的有害副作用更少。
