Systemic Combination Treatment for Psoriasis: A Review

We identified 20 studies in which MTX was given in combination with another systemic drug

P Jensen

2010

Scholarcy highlights

  • Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia
  • Psoriasis is a chronic inflammatory skin disease with an estimated global prevalence ranging from 0.5% to 4.6%, and it affects approximately 2.6% of the population in Northern Europe and Scandinavia
  • Duration of treatment until remission: Group 1: 65.4 days Group 2: 47.8 days Group 3: 57.8 days Number of PUVA exposures until remission: Group 1: 19.9 Group 2: 13.7 Group 3: 16.9 Psoriasis Area Severity Index 75 was achieved in 60% in group 1 vs. 24% in group 2 The median PASI decrease in group 1 was 22 vs. 12 in group 2 At week 12 mean PASI was less in group 1 vs. group 2
  • Combination treatment resulted in PASI reduction of 63.7% Cyclosporine monotherapy resulted in PASI reduction of 70.5% No significant difference between groups Rapamycin monotherapy was not effective No effect on psoriasis of any treatment regimen
  • Patients with moderate-to-severe psoriasis often depend upon systemic combination therapy for varying time periods to achieve and sustain disease remission
  • The most common form, accounts for more than 80% of psoriasis cases
  • The risk of squamous cell carcinoma is increased by cyclosporine in previously PUVA exposed patients and in patients treated with PUVA and high-dose MTX
  • The randomized multicentre study by Reitamo et al examined the effect of rapamycin mono¬≠ therapy vs rapamycin and cyclosporine and found no difference in Psoriasis Area Severity Index reduction between the two groups after 8 weeks

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