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Conventional therapies for psoriasis.

A Rebora1

  • 1Department of Endocrinological and Medical Science, Section of Dermatology, University of Genoa, Italy. rebdermo@unige.it

Reumatismo
|December 6, 2007
PubMed
Summary
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Systemic treatments for psoriasis, including methotrexate, acitretin, and cyclosporin A, show similar efficacy. Cyclosporin A offers the best efficacy/side effect balance for managing psoriasis, though careful patient selection is crucial.

Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Psoriasis treatment involves topical and systemic drugs.
  • Systemic therapy options in Italy include methotrexate, acitretin, and cyclosporin A.

Purpose of the Study:

  • To compare the efficacy and safety profiles of three systemic drugs for psoriasis treatment.
  • To discuss indications, contraindications, interactions, adverse effects, and precautions for methotrexate, acitretin, and cyclosporin A.

Main Methods:

  • Review of systemic psoriasis therapies available in Italy.
  • Comparative analysis of efficacy (PASI 75 at 12 weeks) and adverse event profiles.

Main Results:

  • All three drugs (methotrexate, acitretin, cyclosporin A) achieve PASI 75 in approximately 60% of patients within 12 weeks.

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  • Methotrexate commonly causes nausea, vomiting, and elevated liver enzymes.
  • Acitretin has varied side effects including liver enzyme/lipid increase, renal impairment, and teratogenicity.
  • Cyclosporin A's main side effects are hypertension and renal failure.

    • Conclusions:

    • Cyclosporin A demonstrates the most favorable efficacy/side effect ratio for psoriasis management.
    • Cyclosporin A should be reserved for selected patient cases due to potential side effects.