Pharmacologic profile of tazarotene

The majority of patients with psoriasis exhibit a mild to moderate form of the disease. While topically applied agents represent the ideal therapeutic approach for these patients, our treatment options have been hampered by their inconsistent or limited efficacy, expense, and cosmetic properties. Furthermore, some of the topically applied preparations have the potential for systemic absorption and associated adverse events. Tazarotene is the first synthetically developed retinoid indicated for the topical treatment of patients with psoriasis. Pharmacologically, tazarotene affects the three primary abnormalities associated with psoriasis: it normalizes epidermal differentiation, it exhibits a potent antiproliferative effect, and it decreases epidermal inflammation. Following topical application, tazarotene is rapidly metabolized in the skin to tazarotenic acid, its primary and active metabolite. While tazarotenic acid achieves measurable levels in the systemic circulation, no drug-related hematologic, ophthalmologic, or metabolic adverse events have been observed. Only a minimal amount of tazarotene is absorbed into the circulation. While animal studies have found tazarotene to be nonmutagenic and nonteratogenic, women of child-bearing potential should be counseled regarding the potential risks of retinoid use during pregnancy. In summary, animal and clinical patient trials have found tazarotene to be effective, safe, and well-tolerated. The availability of such an agent in a topical formulation is a welcome treatment alternative for the management of patients with psoriasis.