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Updated: May 6, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
38.4K
Continuous versus intermittent therapy for moderate-to-severe psoriasis.
Marigdalia K Ramirez-Fort1, Adriane A Levin, Shiu-Chung Au
1Department of Dermatology, Tufts Medical Center, Boston, MA, USA. mramirezfort@tuftsmedicalcenter.org.
Clinical and Experimental Rheumatology
|October 17, 2013
Summary
Continuous treatment is best for moderate-to-severe psoriasis, especially with biologic agents like etanercept and adalimumab. Intermittent therapy may reduce efficacy and increase side effects for psoriasis management.
Area of Science:
- Immunodermatology
- Chronic Inflammatory Diseases
Background:
- Psoriasis is a chronic, immune-mediated inflammatory skin condition.
- Historically, intermittent therapy was preferred due to concerns about cumulative toxicity of systemic treatments.
- Biologic agents have enabled continuous treatment options for moderate-to-severe psoriasis.
Purpose of the Study:
- To review and compare the efficacy and safety of intermittent versus continuous treatment strategies for psoriasis.
- To analyze data on phototherapy, topical corticosteroids, conventional systemic therapies, and biologic agents.
Main Methods:
- Literature review of studies on psoriasis treatment modalities.
- Comparative analysis of intermittent versus continuous dosing regimens.
- Evaluation of efficacy and side effect profiles for various therapies.
Main Results:
- Continuous therapy with biologic agents (etanercept, adalimumab, infliximab, ustekinumab) demonstrates superior efficacy and safety.
- Intermittent use of biologics results in decreased effectiveness and potential for increased adverse events.
- Continuous conventional systemic therapy is more effective than intermittent use, but methotrexate and cyclosporine warrant intermittent use due to toxicity concerns.
Conclusions:
- Continuous treatment is optimal for managing moderate-to-severe psoriasis, particularly with advanced biologic therapies.
- While psoriasis severity fluctuates, consistent treatment is crucial for sustained disease control and minimizing skin involvement.
- Treatment strategies should be individualized, balancing efficacy with the cumulative toxicity risks of conventional systemic agents.
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