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Thioguanine for refractory psoriasis: a 4-year experience
1Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, USA.
Journal of the American Academy of Dermatology
|January 10, 2001
Summary
Thioguanine (6-thioguanine) shows promise for severe psoriasis when other treatments fail. While effective, myelosuppression is a key side effect to monitor.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Psoriasis treatment options like methotrexate and cyclosporine are limited by patient non-response and toxicity.
- Refractory psoriasis necessitates exploration of alternative systemic therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of thioguanine (6-thioguanine) in patients with severe, treatment-resistant psoriasis.
Main Methods:
- Retrospective review of 21 patients with psoriasis treated with thioguanine.
- Doses varied (20 mg twice weekly to 120 mg daily); most patients had prior methotrexate treatment.
Main Results:
- 78% of evaluable patients experienced >90% improvement in psoriasis.
- 17% had 50%-90% improvement; 5% had <50% improvement.
- Myelosuppression was the primary side effect, ranging from mild to severe.
Conclusions:
- Thioguanine is an effective option for severe recalcitrant psoriasis.
- Myelosuppression is a manageable side effect, predictable with thiopurine methyltransferase testing.
- Further studies are needed to optimize thioguanine treatment protocols for psoriasis.