Comparison of etretinate (Tigason) and parenteral gold in the treatment of psoriatic arthropathy.

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.