Acitretina: guía de uso en psoriasis

Carretero, G.; Ribera, M.; Belinchón, Isabel; Carrascosa, J.M.; Puig, L.; Ferrándiz, Carlos; Dehesa, Luis; Vidal, David; Peral, Fernando Zamanillo; Jorquera, E.; Gonzalez-Quesada, A.; Muñoz, César Velasco; Notario, J.; Vanaclocha, F.; Moreno, J.C.

doi:10.1016/j.ad.2013.01.003

Cited by 47 publications

(18 citation statements)

References 127 publications

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“…Moreover, MTX decreases interleukin-1 and -6 secretion and at the same time increases interleukins-4 and -10 gene expression and decreases gene expression of proinflammatory Th1 cytokines [57]. In research conducted by Dehpouri et al, the scientists highlighted that MTX does not negatively affect the glucose metabolism in patients with psoriasis arthritis and can be safely used in the treatment of psoriasis and psoriatic arthritis, especially with coexisting diabetes mellitus and metabolic syndrome [58]. Acitretin possess a unique role in the treatment of psoriasis because its mechanism of action is different from other systemic drugs [59].…”

Section: Discussionmentioning

confidence: 99%

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Krahel

Baran

Kamiński

et al. 2020

JCM

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Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) exerts an important role in inflammatory processes, lipids homeostasis, and cardiometabolic disorders that are closely associated with psoriasis. The aim of the study was to analyze the clinical and diagnostic value of serum PCSK9 concentrations and their connections with disease severity, inflammation, metabolic syndrome, and impact of systemic therapies in psoriatic patients. The study enrolled thirty-five patients with active plaque-type psoriasis and eighteen healthy volunteers served as controls. Blood samples were obtained before and after 12 weeks of treatment with methotrexate or acitretin. Serum PCSK9 concentrations were measured by the ELISA (Enzyme-Linked Immunosorbent Assay) commercial kits. Morphological and biochemical parameters were assayed using routine laboratory techniques. Psoriatic patients showed significantly elevated levels of PCSK9 compared to controls (p < 0.01), mostly in patients with a mild and moderate course of psoriasis. PCSK9 concentrations correlated positively with BMI and triglyceride levels (p < 0.05). Interestingly, PCSK9 had a strong negative correlation with low-density lipoprotein levels and total cholesterol (p < 0.05). Three months of monotherapy with methotrexate significantly reduced PCSK9 level (p < 0.05), on the contrary, the acitretin group showed a further increase of PCSK9 levels (p < 0.05). PCSK9 seems to be a novel marker of psoriasis and a putative explanation of lipid disturbances, which are common in patients with psoriasis and are vital for the further developing of metabolic syndrome. Methotrexate should be considered as a treatment of choice in patients with an elevated PCSK9 concentration.

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Section: Discussionmentioning

confidence: 99%

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Krahel

Baran

Kamiński

et al. 2020

JCM

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“…Systemic treatments such as acitretin, methotrexate, and etanercept decrease the numbers of proinflammatory cells (such as Th1 and Th17 cells) and increase those of anti-inflammatory cells (such as Tregs) in psoriatic skin lesions and in serum 32,33,37,38 . Acitretin downregulates the expression of interferon-γ as well as that of IL-17 32 . Therefore, the levels of proinflammatory cytokines may have been lower in the subjects in the systemically treated group than those in the non-systemically treated group.…”

Section: Discussionmentioning

confidence: 99%

Risk of End-Stage Renal Disease in Psoriatic Patients: Real-World Data from a Nationwide Population-Based Cohort Study

Lee¹,

Han

Bang

et al. 2019

Sci Rep

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Psoriasis is a chronic inflammatory skin disorder mediated by the T-cell–related immune response. Psoriatic patients may have a variety of comorbidities, but their risk of end-stage renal disease (ESRD), particularly according to the subtype of psoriasis, is unclear. We investigated the risk of ESRD in patients with psoriasis according to the subtype of psoriasis and history of systemic therapy for psoriasis. A total of 2,121,228 adults (1,590,921 in the control group and 530,307 in the psoriasis group) were enrolled in this nationwide population-based cohort study until 2015. During follow-up, 1,434 of the subjects in the psoriasis group developed ESRD. After adjusting for confounding factors, psoriasis was associated with the risk of ESRD (hazard ratio (HR) 1.58, 95% confidence interval [95% CI] 1.47–1.68). The psoriatic arthritis group (HR 7.60, 95% CI 1.90–30.41) had a higher risk of ESRD than the control group. Interestingly, no such association was detected in the systemically treated group (HR 1.07, 95% CI 0.80–1.41). Moreover, the acitretin-treated group had a lower risk of ESRD (HR 0.658, 95% CI, 0.494–0.875) than the non-systemically treated group. In conclusion, the risk of developing ESRD in patients with psoriasis differed according to the type of treatment and the presence of arthritis.

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“…En la actualidad existen numerosos documentos de consenso españoles que indican las posibles combinaciones de fármacos para el tratamiento de la psoriasis 19,22,28,32,33 , y en concreto, el Documento de Consenso de las Directrices españolas basadas en la evidencia para el tratamiento de la psoriasis moderada a grave con agentes biológicos indica la terapia combinada de los medicamentos biológicos y sistémicos 26 . Sin embargo, en la actualidad dichas combinaciones aún no han sido aprobadas para el tratamiento de la psoriasis moderada a grave 34 .…”

Section: ) Combinaciones Terapéuticasunclassified

Retorno social de la inversión de un abordaje ideal de la Psoriasis

González¹,

Ivanova²,

Jiménez³

et al. 2016

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Acitretina: guía de uso en psoriasis

Cited by 47 publications

References 127 publications

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Risk of End-Stage Renal Disease in Psoriatic Patients: Real-World Data from a Nationwide Population-Based Cohort Study

Retorno social de la inversión de un abordaje ideal de la Psoriasis

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