Etretinate. Persistent serum levels after long-term therapy

DiGiovanna, John J.; Zech, Loren A.; Ruddel, M; Gantt, Gail; Peck, Gary L.

doi:10.1001/archderm.125.2.246

Cited by 29 publications

(20 citation statements)

References 14 publications

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“…Retinoids have been reported efficacious in the treatment of ARCI based on case reports and series (5)(6)(7)(8)(9)(10)(11)(33)(34)(35)(36)(37)(38). In many patients, marked improvement or remission has been reported as long as the drug is continued, which for many patients has spanned decades ( Fig.…”

Section: Autosomal-recessive Congenital Ichthyosis (Arci)mentioning

confidence: 99%

Systemic retinoids in the management of ichthyoses and related skin types

et al. 2013

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The term retinoid includes both natural and synthetic derivatives of vitamin A. Retinoid containing treatments have been used since the early Egyptians ~1550BC. Treatment of ichthyosiform disorders with retinoids dates back at least to the 1930’s. Early use of high dose vitamin A demonstrated efficacy but, because vitamin A is stored in the liver, toxicity limited usefulness. Interest turned to synthetic retinoids in an effort to enhance efficacy and limit toxicity. Acetretin, isotretinoin and, in the past etretinate, have provided the most effective therapy for ichthyosiform conditions. They have been used for a variety of ages, including in newborns with severe ichthyosis and for decades in some patients. Careful surveillance and management of mucous membrane, laboratory, skeletal, and teratogenic side effects has made systemic retinoids the mainstay of therapy for ichthyosis and related skin types.

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Section: Autosomal-recessive Congenital Ichthyosis (Arci)mentioning

confidence: 99%

Systemic retinoids in the management of ichthyoses and related skin types

et al. 2013

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“…Based on this, acitretin is given FDA pregnancy category X, and is contraindicated in pregnant women. The elimination half-life of acitretin is 33-96 h; however, acitretin has the potential to re-esterify to etretinate with a much longer elimination half-life of up to 150 weeks [68][69][70], which requires the use of contraception for 2-3 years after cessation of acitretin. It is therefore recommended that acitretin is completely avoided in women with childbearing potential.…”

Section: Acitretinmentioning

confidence: 99%

Treating Psoriasis During Pregnancy: Safety and Efficacy of Treatments

2015

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Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well as the effects of psoriasis treatment options on the developing fetus. Although there are no robust data on the safety of systemic treatment of pregnant women, increasing evidence regarding the safety of cyclosporine (ciclosporin) treatment as well as anti-tumor necrosis factor-α is available and should be considered in pregnant women with moderate to severe psoriasis unresponsive to local corticosteroids and UVB light treatment.

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“…Therefore, single-dose pharmacokinetic data are of limited value for predicting steady-state concentrations. DiGiovanna et al (1989) studied serum etretinate concentrations after discontinuation of therapy in 47 patients with various disorders of keratinisation. Detectable serum concentrations (0.05 to 1.2 mg/L) were observed up to 150 weeks after stopping therapy.…”

Section: Multiple-dose Pharmacokinetics In Disorders Of Keratinisationmentioning

confidence: 99%

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

Larsen

Nielsen‐Kudsk

Jakobsen

et al. 1992

Clinical Pharmacokinetics

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The retinoids are a class of compounds that includes the natural forms and synthetic analogues of vitamin A. Isotretinoin, often referred to as a first generation retinoid, may be of considerable benefit to patients with severe, recalcitrant acne. Etretinate and acitretin, 2 aromatic compounds representing the second generation, have found their major success in the treatment of psoriasis, particularly in combination with more traditional therapies. Retinoid therapy is associated with a distinctive adverse effect profile typical of hypervitaminosis A; thus, it is especially important that fertile women undergoing retinoid therapy adhere to a contraceptive regimen. These drugs are extensively metabolised and only traces of unchanged drugs are eliminated in urine. The terminal elimination half-lives of isotretinoin, etretinate and acitretin after long term treatment are up to 20h, 120 days and 48h, respectively. Because of lack of definite correlation between plasma concentration and desired pharmacological effects, in conjunction with the very pronounced inter- and intraindividual variation in systemic availability (15 to 90%) after oral administration of these drugs, initial dosages in individual patients can only be roughly judged on the basis of the general pharmacokinetics of the agents. Later dosage adjustments should be made on the basis of monitoring of both plasma drug (and possible metabolite) concentrations, and the efficacy and tolerability of the drugs.

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Etretinate. Persistent serum levels after long-term therapy

Cited by 29 publications

References 14 publications

Systemic retinoids in the management of ichthyoses and related skin types

Systemic retinoids in the management of ichthyoses and related skin types

Treating Psoriasis During Pregnancy: Safety and Efficacy of Treatments

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

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