Monotherapy and combination therapy with acitretin for mycosis fungoides: results of a retrospective, multicentre study
| Autor: | Triantafyllia Koletsa, Alexander J. Stratigos, Dimitris Rigopoulos, Afroditi Economidi, Aikaterini Patsatsi, Polytimi Sidiropoulou, Evangelia Papadavid, E. Georgiou, Vasiliki Nikolaou, Sabine‐Elke Kruger‐Krasagakis, Eirini Kavvalou, Gregory Chlouverakis |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms Combination therapy Drug intolerance Dermatology Acitretin 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Mycosis Fungoides medicine Humans Adverse effect Retrospective Studies Mycosis fungoides Greece business.industry Retrospective cohort study medicine.disease Regimen Infectious Diseases Hair loss Treatment Outcome 030220 oncology & carcinogenesis Female business medicine.drug |
| Zdroj: | Journal of the European Academy of Dermatology and Venereology : JEADVReferences. 34(11) |
| ISSN: | 1468-3083 |
| Popis: | Background Retinoids have long been used in the treatment of cutaneous T-cell lymphomas. However, data on acitretin use for mycosis fungoides (MF) are very limited. Objectives To evaluate treatment outcomes of acitretin in patients with MF attending three academic referral centres in different regions of Greece. Methods Data on effectiveness, safety and drug survival of acitretin as monotherapy or as adjuvant regimen were collected in a multicentre, register-based, retrospective study. Results Overall, 128 patients (64.8% male; mean age at MF diagnosis 59.7 years) were included. Folliculotropic MF was present in 24 (18.8%) cases. Most patients (n = 118; 92.2%) had early-stage disease (≤IIA) at acitretin initiation. In all, 28 (21.9%) patients received acitretin monotherapy, while 100 (78.1%) subjects on acitretin concomitantly received phototherapy (n = 65; 50.8%) or topical steroids (n = 27; 21.1%). Acitretin was given as a first-line agent in 73 (57%) cases. A 77.3% overall response rate was noted: 44.5% and 32.8% for complete and partial responses, respectively. Acitretin was more effective as first-line than as a subsequent agent (P = 0.008). A trend towards better response was observed in the combination arm compared to patients receiving acitretin alone (P = 0.056). Median time to best response was 6.9 months (IQR 4.4-9.4); median duration of response was 23.7 months (IQR 11.9-35.4). Overall, the mean length of all treatment patterns was 569 days (SD 718.8). Therapy was discontinued in 5 (3.9%) cases due to drug intolerance. Adverse effects were recorded in 62 (48.4%) cases with dyslipidaemia (n = 31; 24.2%), xerosis (n = 24; 18.6%) and hair loss (n = 10; 7.8%) being the most commonly recorded. Conclusions Acitretin, either alone or as adjuvant, showed a stable long-term effectiveness in this cohort, especially when used in the first-line setting. This RAR-selective agonist may serve as an attractive option for treatment of MF and should be further evaluated. |
| Databáze: | OpenAIRE |
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