Tigason (etretinate) treatment in psoriatic arthritis

Tigason (etretinate, RO-10-9359) is an oral aromatic retinoid acid which is effective in psoriasis and other dermatological syndromes. The present study reports the results of the use of this drug in 15 patients with a confirmed diagnosis of psoriatic arthritis, aged between 42 and 74 (average 60.2) years. Two patients dropped out after one month because they showed dryness of lips, chapping and intolerable itching, and another two due to intolerable pruritus and deterioration of their skin lesions. The 11 remaining patients, five males and six females, were treated with a daily dose of 50 mg etretinate, reduced to 25 mg after two weeks. Assessments which included grip strength, Ritchie joint index, pain, and dermatological assessment were performed at monthly intervals. Routine blood tests for toxic effects and erythrocyte sedimentation rate (ESR) were also performed, as well as CPR (C-protein reactive) as a test of disease activity. All patients showed an improvement in the psoriasis, joint swelling and pain. The elevated ESR observed in all patients studied also fell gradually during the course of etretinate treatment, as did as the intake of antiinflammatory agents. Elevated serum lipid levels (cholesterol and triglycerides) were found in three patients; further drug-specific side-effects such as dryness of lips and mouth, loss of hair, thinning of skin and scaling were frequently found in all patients, but they remained tolerable.