Nonstandard and off-label therapies for psoriasis

Halverstam, Caroline; Lebwohl, Mark

doi:10.1016/j.clindermatol.2007.10.023

Cited by 44 publications

(38 citation statements)

References 52 publications

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“…Recently developed anti-psoriatic therapies (e.g., ustekinumab and ABT-874) predominantly target specific components of the immune system, such as TNF␣, or molecules involved in T-cell activation (12)(13)(14); however, no cure is currently available (15). Surprisingly anti-angiogenic treatments for chronic inflammatory conditions have received little attention thus far, although some therapies for psoriasis, such as paclitaxel and shark fin cartilage, are thought to have an antiangiogenic effect (16). Moreover, the prominent involvement of angiogenesis in the pathogenesis of psoriasis and the validated use of anti-angiogenic therapy in human cancers using a monoclonal antibody directed against VEGF (bevacizumab, Avastin R ) (17, 18) suggests anti-VEGF treatment as a possible therapy for patients suffering from psoriasis.…”

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confidence: 99%

Systemic anti-VEGF treatment strongly reduces skin inflammation in a mouse model of psoriasis

Schönthaler

Huggenberger

Wculek

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

135

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Although , vascular remodeling is a hallmark of many chronic inflammatory disorders such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, anti-vascular strategies to treat these conditions have received little attention to date. We investigated the anti-inflammatory activity of systemic blockade of VEGF-A by the inhibitory monoclonal antibody G6 -31, employing a therapeutic trial in a mouse model of psoriasis. Simultaneous deletion of JunB and c-Jun (DKO*) in the epidermis of adult mice leads to a psoriasis-like phenotype with hyper-and parakeratosis and increased subepidermal vascularization. Moreover, an inflammatory infiltrate and elevated levels of cytokines/chemokines including TNF␣, IL-1␣/␤, IL-6, and the innate immune mediators IL-22, IL-23, IL-23R, and IL-12p40 are detected. Here we show that anti-VEGF antibody treatment of mice already displaying disease symptoms resulted in an overall improvement of the psoriatic lesions leading to a reduction in the number of blood vessels and a significant decrease in the size of dermal blood and lymphatic vessels. Importantly, anti-VEGF-treated mice showed a pronounced reduction of inflammatory cells within the dermis and a normalization of epidermal differentiation. These results demonstrate that systemic blockade of VEGF by an inhibitory antibody might be used to treat patients who have inflammatory skin disorders such as psoriasis.activator protein-1 ͉ Jun proteins ͉ epidermis ͉ angiogenesis ͉ G6-31 antibody

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mentioning

confidence: 99%

Systemic anti-VEGF treatment strongly reduces skin inflammation in a mouse model of psoriasis

Schönthaler

Huggenberger

Wculek

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

135

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“…Corticosteroids were prescribed in only 32% of our patients, in contrast with their use in the majority of children in germany (72.2%) 2 and turkey (92%) 8 . the off-label use of dapsone is due to its anti-inflammatory and immunomodulatory effects; it has merely been employed in case series of psoriasis, with a good response 19 . the use of systemic antibiotics was proportional with the number of patients with guttate psoriasis, likely due to the induction or exacerbation of psoriatic lesions by bacterial toxins 20,21 .…”

Section: Resultsmentioning

confidence: 99%

“…We conducted a retrospective study between January 19,1999 and December 31, 2014 at an academic, tertiary care dermatology center. We collected data from the medical charts and records of the histopathology department at the same center.…”

Section: Methodsmentioning

confidence: 99%

Psoriasis in Children and Adolescents: Epidemiological Study of 280 Patients from Mexico

Tovar‐Garza

Meza-Reséndiz

Guevara‐Gutiérrez

et al. 2017

RIC

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“…8 Pode ser prescrita em dose única ou ser dividida em duas tomadas, estando a última forma associada a menor incidência de náuseas e vômitos.…”

Section: Azatioprinaunclassified

Imunossupressores na Dermatologia

Bressan

Silva

Fontenelle³

et al. 2010

An. Bras. Dermatol.

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Resumo: Os imunossupressores são drogas que agem na divisão celular e têm propriedades anti-inflamatórias. Sendo assim, são essencialmente prescritos na prevenção de rejeição de transplantes e no tratamento das doenças autoimunes e inflamatórias crônicas, que, na Dermatologia, têm a psoríase como maior representante. Nesta sessão serão descritas as principais drogas imunossupressoras, com orientações para seu manejo adequado. Palavras-chave: Azatioprina; Ciclofosfamida; Ciclosporina; Imunossupressores; Metotrexato Abstract: Immunosupressants are drugs that act in cell division and have anti-inflammatory effects. Therefore, they are essentially prescribed in the prevention of transplant rejection and in the treatment of autoimmune disorders and chronic inflammatory diseases, whose main example in Dermatology is psoriasis. In this work the most important immunosuppressive drugs and orientation to properly administer them are going to be described. INTRODUÇÃOO tratamento imunossupressor é necessário para prevenir a rejeição de um órgão transplantado e também atua contra doenças inflamatórias, alvo principal da Dermatologia. Essa classe de drogas age inibindo a divisão celular, além de possuir propriedade antiinflamatória. Seu uso é indicado em psoríase, pênfigos e penfigoides, linfomas, entre outras patologias.Antes de iniciar uma terapia imunossupressora, é necessário conhecer as indicações, as contraindicações, os efeitos adversos e as interações medicamentosas, para poder minimizar os riscos do tratamento. Em alguns casos, ela pode ser prescrita para crianças, mas o calendário vacinal deve estar atualizado (vacinar 2-4 semanas antes do início do tratamento) e é preciso evitar vacina de vírus vivo durante este. 1 Além disso, algumas condutas deverão ser seguidas, como: anamnese (levando-se em conta a idade, os fármacos em uso e as comorbidades); realização de profilaxia para estrongiloidíase e esclarecimento ao paciente sobre a nova terapia. A rotina de exames pré-tratamento determinará, com a clínica, o medicamento mais indicado e sua respectiva dose.O objetivo de qualquer terapia médica é proporcionar cura e/ou alívio de doenças com o menor dano possível ao paciente. Isso está sendo alcançado graças ao vasto arsenal de drogas e agentes biológicos que tem possibilitado terapias imunossupressoras mais adaptadas às necessidades individuais dos pacientes. São as seguintes as premissas da individualização da imunossupressão: diferenças nos níveis de

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Nonstandard and off-label therapies for psoriasis

Cited by 44 publications

References 52 publications

Systemic anti-VEGF treatment strongly reduces skin inflammation in a mouse model of psoriasis

Systemic anti-VEGF treatment strongly reduces skin inflammation in a mouse model of psoriasis

Psoriasis in Children and Adolescents: Epidemiological Study of 280 Patients from Mexico

Imunossupressores na Dermatologia

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