Single‐center retrospective study of long‐term use of low‐dose acitretin (Soriatane®) for psoriasis

Abstract

Acitretin does not appear to cause significant long-term side effects at low doses; the implications for thousands of patients are that use of this medication can be continued for long periods of time with routine monitoring.

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

“…106 A further retrospective study of long-term acitretin revealed no cases of DISH. 107 Regular radiological evaluations have been suggested in the literature but the evidence does not support this practice which exposes subjects to unnecessary radiation; our consensus is that routine radiographic assessments are not required for long-term acitretin therapy. Targeted X-rays for atypical musculoskeletal pain may be informative.…”

Low-Dose Acitretin Is Associated With Fewer Adverse Events Than High-Dose Acitretin in the Treatment of Psoriasis

“…As a systemic retinoid, acitretin is metabolized by the liver and has the potential to perturb hepatic function. Another known adverse effect of acitretin in some individuals is the potential to elevate serum triglycerides (TGs) to significant levels; routine monitoring is advised 4,5 (also K.K.Z., E.J.M., D.J.P., R.R., and S.R.F., unpublished data, 2005). Despite this adverse effect profile, acitretin features prominently in many monotherapy and combination regimens.…”

“…2,3 Although skeletal hyperostosis is seen infrequently with long-term use of high-dose acitretin and although acitretin is teratogenic, this agent has the advantage of none of the cumulative toxicities seen with traditional systemic psoriasis treatments. 4 The effectiveness and safety of acitretin for treatment of psoriasis were evaluated more than a decade ago in 2 pivotal trials (Connetics Corporation, data on file, 1996). Results from these trials showed 50-mg/d acitretin to have superior effectiveness compared with placebo and with lower doses after 8 weeks of treatment.…”

A review of acitretin, a systemic retinoid for the treatment of psoriasis

“…Lee and Koo did not find any confirmed cases of diffuse idiopathic skeletal hyperostosis (DISH) syndrome in a chart review of all patients seen at the UCSF Psoriasis Treatment Center over the past two decades who had been on acitretin or etretinate for > 1 year [70]. They also performed a literature review and did not find any paper reporting an increased risk of DISH syndrome in low-dose acitretin 25 mg/day (or less) in psoriasis [70].…”

“…They also performed a literature review and did not find any paper reporting an increased risk of DISH syndrome in low-dose acitretin 25 mg/day (or less) in psoriasis [70].…”