Combination therapy to treat moderate to severe psoriasis

Lebwohl, Mark; Menter, Alan; Koo, John; Feldman, Steven R.

doi:10.1016/j.jaad.2002.12.002

Cited by 162 publications

(125 citation statements)

References 90 publications

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“…38 The combination of methotrexate and acitretin has been used in patients with severe psoriasis, where all other treatments have failed. 39,40 This has been based on anecdotal evidence extrapolated from etretinate. 41 Although this combination can be very effective, sporadic severe hepatotoxic responses have been reported.…”

Section: Other Combinationsmentioning

confidence: 99%

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Ormerod

Campalani

Goodfield

2010

British Journal of Dermatology

126

154

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Section: Other Combinationsmentioning

confidence: 99%

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Ormerod

Campalani

Goodfield

2010

British Journal of Dermatology

126

154

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“…49 Thus, treatments aimed at the metabolism and signaling of vitamin D3 could be beneficial in cutaneous inflammatory diseases. 48,53 In psoriasis, blocking the expression of human peptides of cathelicidins (LL-37) can inhibit the activation of dendritic cells and cutaneous inflammation. 53 Paradoxically, vitamin D3 analogues were used for a long time in the treatment of psoriasis.…”

Section: Inflammatory Cutaneous Diseasesmentioning

confidence: 99%

“…48,53 In psoriasis, blocking the expression of human peptides of cathelicidins (LL-37) can inhibit the activation of dendritic cells and cutaneous inflammation. 53 Paradoxically, vitamin D3 analogues were used for a long time in the treatment of psoriasis. Those compounds bind vitamin D receptors, activating them, therefore increasing the levels of cathelicidins in the keratinocytes and, presumably, worsening inflammation.…”

Section: Inflammatory Cutaneous Diseasesmentioning

confidence: 99%

“…However, the opposite occurs: improvement of cutaneous inflammation and reversion of the morphological changes in damaged skin. 53 The use of vitamin D3 and its analogues in the treatment of psoriasis has been studied for several years, demonstrating the effects of calcitriol on the improvement of psoriatic lesions. However, due to hypercalcemia and hypercalciuria, longterm use of those agents is limited.…”

Section: Inflammatory Cutaneous Diseasesmentioning

confidence: 99%

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A importância dos níveis de vitamina D nas doenças autoimunes

Marques¹,

Dantas²,

Fragoso³

et al. 2010

Rev. Bras. Reumatol.

103

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“…2 Combining agents allows the treating physician not only to exploit synergistic effects, but also avoid otherwise toxic doses necessaries to achieve clearance in monotherapeutic regimens. 38 Even though single-agent therapies may have lower costs and better chance for compliance, more often than not, a single modality will not be sufficient to reach all expectations (such as complete skin clearance, psoriatic arthritis control when applicable, improved quality of life, low rate of adverse events).…”

Section: Current Therapy Optionsmentioning

confidence: 99%

Ustekinumab: an evidence-based review of its effectiveness in the treatment of psoriasis

Krulig

Gordon

2010

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Introduction: Psoriasis is a chronic inflammatory skin disease affecting approximately 2% to 3% of the population worldwide. Discoveries over the past 3 to 5 years have significantly altered our view of psoriasis as primarily a T-cell mediated condition. The most recent research has demonstrated the essential role of specific cytokines in the development of this complex disease, including TNF-α, interleukin-23 (IL-23), and potentially, IL-22. These are all part of a newly defined autoimmune pathway directed by specialized T cells called Th17 helper T cells. Ustekinumab is a fully human monoclonal antibody that targets IL-12 and IL-23, thus targeting both Th1 and Th17 arms of immunity. It has a promising efficacy and safety profile that not only represents a valuable treatment alternative, but also a continuation in our constantly evolving understanding of this disorder. Aims: To review the emerging evidence supporting the use of ustekinumab in the management of moderate to severe plaque psoriasis. Evidence review: There is clear evidence that ustekinumab is effective in the treatment of moderate to severe psoriasis. Phase III trials (PHOENIX 1 and 2) demonstrated a statistically significant difference between Psoriasis Area and Severity Index (PASI) 75 responses achieved by patients receiving ustekinumab, given as a 45 mg or 90 mg subcutaneous injection every 12 weeks, than their placebo counterparts. Treatment with this novel agent resulted in a rapid onset of action, with over 60% of treated patients attaining Physician's Global Assessment (PGA) scores of "cleared" or "minimal" by week 12. Quality of life assessments paralleled clinical improvements. Clinical potential: Ustekinumab is an effective and efficient therapeutic option for patients with moderate to severe psoriasis. Although further studies are required to establish ustekinumab's place in the therapy of psoriasis, with its convenient dosing schedule and rapid onset of action, this drug could provide a great addition to the current therapeutic armamentarium available for psoriatic patients.

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Combination therapy to treat moderate to severe psoriasis

Cited by 162 publications

References 90 publications

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

A importância dos níveis de vitamina D nas doenças autoimunes

Ustekinumab: an evidence-based review of its effectiveness in the treatment of psoriasis

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