Related Experiment Video
Updated: Jul 5, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Combining systemic retinoids with biologic agents for moderate to severe psoriasis
Elizabeth C A Smith1, Christy Riddle, M Alan Menter
1Department of Dermatology, Mount Sinai School of Medicine, New York, USA. elizabeth.smith@mssm.edu
International Journal of Dermatology
|April 17, 2008
Summary
Combining acitretin with biologic agents shows promise for treating severe psoriasis. This combination therapy demonstrated significant patient improvement and reduced the need for additional treatments, though long-term safety requires further study.
Area of Science:
- Dermatology
- Immunology
Background:
- Psoriasis affecting over 20% of body surface area often necessitates combination therapy for remission.
- Limited data exist on the efficacy, safety, and tolerability of combining acitretin with biologic agents for psoriasis management.
Purpose of the Study:
- To evaluate the efficacy, safety, and tolerability of concomitant acitretin and biologic agent therapy in patients with moderate to severe psoriasis.
Main Methods:
- Retrospective chart review of fifteen patients with psoriasis treated with acitretin and a biologic agent.
- Data collected included therapeutic response, need for additional therapies, side-effects, and laboratory abnormalities.
Main Results:
- Significant psoriasis improvement observed: 29% clearance, 43% 90% improvement, 14% 75% improvement.
- Combination therapy reduced the need for adjunctive treatments, including phototherapy (UV-B).
- Three patients developed squamous cell carcinoma (SCC), all with prior history; one developed non-Hodgkin's lymphoma.
Conclusions:
- Acitretin combined with biologic agents presents a viable option for managing refractory psoriasis.
- Further research is essential to establish long-term safety and efficacy profiles of this combination therapy.
Related Concept Videos
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
01:27Acne Infection
Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...