Risk:benefit ratio in the treatment of psoriasis with systemic retinoids

Halioua, Bruno; Saurat, Jean‐Hilaire

doi:10.1111/j.1365-2133.1990.tb02891.x

Cited by 20 publications

(4 citation statements)

References 132 publications

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“…However, all of these treatments have limitations in addition to their clinical benefit. Long‐term use of systemic therapies is limited by safety considerations, including organ toxicity, infection and malignancy, and teratogenicity with systemic retinoids, such as etretinate . Phototherapy is associated with increased risk of skin malignancies, while some patients do not respond to phototherapy or have disease recurrence, and multiple office visits are required.…”

Section: Introductionmentioning

confidence: 99%

“…Long-term use of systemic therapies is limited by safety considerations, including organ toxicity, infection and malignancy, 15,16 and teratogenicity with systemic retinoids, such as etretinate. 17 Phototherapy is associated with increased risk of skin malignancies, 18,19 while some patients do not respond to phototherapy or have disease recurrence, and multiple office visits are required. The efficacy of biologic therapies may diminish over time owing in part to immunogenicity and use is restricted by parenteral administration.…”

Section: Introductionmentioning

confidence: 99%

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Oral tofacitinib efficacy, safety and tolerability in Japanese patients with moderate to severe plaque psoriasis and psoriatic arthritis: A randomized, double‐blind, phase 3 study

Asahina¹,

Etoh²,

Igarashi³

et al. 2016

The Journal of Dermatology

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Tofacitinib is an oral Janus kinase inhibitor that is being investigated for psoriasis and psoriatic arthritis. Japanese patients aged 20 years or more with moderate to severe plaque psoriasis and/or psoriatic arthritis were double‐blindly randomized 1:1 to tofacitinib 5 or 10 mg b.i.d. for 16 weeks, open‐label 10 mg b.i.d. for 4 weeks, then variable 5 or 10 mg b.i.d. to Week 52. Primary end‐points at Week 16 were the proportion of patients achieving at least a 75% reduction in Psoriasis Area and Severity Index (PASI75) and Physician's Global Assessment of “clear” or “almost clear” (PGA response) for psoriasis, and 20% or more improvement in American College of Rheumatology criteria (ACR20) for patients with psoriatic arthritis. Safety was assessed throughout. Eighty‐seven patients met eligibility criteria for moderate to severe plaque psoriasis (5 mg b.i.d., n = 43; 10 mg b.i.d., n = 44), 12 met eligibility criteria for psoriatic arthritis (5 mg b.i.d., n = 4; 10 mg b.i.d., n = 8) including five who met both criteria (10 mg b.i.d.). At Week 16, 62.8% and 72.7% of patients achieved PASI75 with tofacitinib 5 and 10 mg b.i.d., respectively; 67.4% and 68.2% achieved PGA responses; all patients with psoriatic arthritis achieved ACR20. Responses were maintained through Week 52. Adverse events occurred in 83% of patients through Week 52, including four (4.3%) serious adverse events and three (3.2%) serious infections (all herpes zoster). No malignancies, cardiovascular events or deaths occurred. Tofacitinib (both doses) demonstrated efficacy in patients with moderate to severe plaque psoriasis and/or psoriatic arthritis through 52 weeks; safety findings were generally consistent with prior studies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral tofacitinib efficacy, safety and tolerability in Japanese patients with moderate to severe plaque psoriasis and psoriatic arthritis: A randomized, double‐blind, phase 3 study

Asahina¹,

Etoh²,

Igarashi³

et al. 2016

The Journal of Dermatology

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“…If topical treatments are unsuccessful, phototherapies with UVB, photochemotherapy (PUVA), methotrexate, cyclosporine, and acitretin are the most common therapeutic options 2 . However, the risk of teratogenicity, the most serious side effect of acitretin and its metabolites, can pose problems for young women of reproductive age 3 . Individuals taking medications with potential teratogenicity are prohibited from donating blood in Korea; the deferral period is variable according to the characteristics of the drug.…”

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confidence: 99%

Evaluation of the transfusion safety of blood products and determination of plasma concentrations of acitretin and etretinate in patients receiving transfusions

Park

Kim

et al. 2008

Transfusion

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“…As a result, combination therapeutic regimens including steroids plus other medications are employed as "steroid-sparing" therapies.Psoriasis is a chronic disease affecting approximately 2% of the population and involving primarily the skin and, to a lesser extent, the joints, nails, and mucous membranes.192 Generally, lesions are characterized as scaling, erythematous, thickened areas. Psoriasis includes chronic plaque, pustular, and erythrodermic forms 193. Several cases of desquamative gingivitis have histologically been associated with psoriasis.…”

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confidence: 99%