An attempt to formulate an evidence-based strategy in the management of moderate-to-severe psoriasis: a review of the efficacy and safety of biologics and prebiologic options
| Autor: | John Koo, Alain Nguyen, Argentina Leon, Julie Letsinger |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Recombinant Fusion Proteins Population Efalizumab Alefacept Antibodies Monoclonal Humanized Psoriasis Area and Severity Index Psoriasis medicine Adalimumab Humans Pharmacology (medical) education PUVA Therapy Randomized Controlled Trials as Topic Pharmacology education.field_of_study Biological Products Evidence-Based Medicine business.industry Antibodies Monoclonal General Medicine Evidence-based medicine medicine.disease Dermatology Infliximab Acitretin Clinical trial Biological Therapy Methotrexate Dermatologic Agents business medicine.drug |
| Zdroj: | Expert opinion on pharmacotherapy. 8(5) |
| ISSN: | 1744-7666 |
| Popis: | Psoriasis is a chronic skin disorder affecting up to 2.5% of the world's population. Despite the myriad treatment options available, there is no uniformly accepted therapeutic approach for moderate-to-severe psoriasis. The objective of this review is to evaluate the relative efficacy and safety of available therapeutic options and to formulate general recommendations for the treatment of moderate-to-severe psoriasis. MEDLINE and Evidence Based Medicine (Cochrane) were used to perform a comprehensive search of the literature from 1986 to 2006. The most scientifically rigorous clinical trial published in the literature was selected for Psoriasis Area and Severity Index (PASI 75) comparison. Only information from clinical trials, human subjects and English language journals are reported in this study. The percentage of PASI 75 reduction at approximately 12 weeks obtained by the following treatment options were: Goeckerman and RePUVA, 100%; calcipotriene plus PUVA, 87%; ciclosporin, 78.2-80.3%; infliximab, 80%; adalimumab 40 mg every other week, 53% and 40 mg/week, 80%; PUVA, 63%; methotrexate, 60%; NB-UVB, 55%; acitretin 52%; etanercept 50 mg twice weekly, 49% and 25 mg twice weekly, 34%; efalizumab, 31.4%; and alefacept 21%. Psoriatic treatments with safer profiles compared with other agents include bath PUVA, Goeckerman and RePUVA. Based on the literature review of efficacy and safety of biologics and prebiologic treatment options for moderate-to-severe psoriasis, the risk:benefit ratio seems most favorable for Goeckerman and RePUVA, followed by either etanercept or adalimumab. |
| Databáze: | OpenAIRE |
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