Guidelines for the Use of Acitretin in Psoriasis

    July 2013 in “ Actas Dermo-Sifiliográficas
    G. Carretero, M. Ribera, I. Belinchón, J.M. Carrascosa, L. Puig, Carlos Ferrándiz, Luis Dehesa, David Vidal, Fernando Zamanillo Peral, E. Jorquera, Alicia González-Quesada, César Velasco Muñoz, J. Notario, F. Vanaclocha, J.C. Moreno
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    TLDR Acitretin is effective for severe psoriasis and can be used long-term due to no immunosuppression, but must be carefully monitored for side effects and is not for pregnant women.
    The 2013 document provides comprehensive guidelines for the use of acitretin in psoriasis treatment, emphasizing its utility as monotherapy or in combination with other treatments, including phototherapy. Acitretin is particularly effective for severe psoriasis types and has a favorable profile due to its lack of immunosuppressive effects, allowing for long-term use. The guidelines cover dosing, efficacy, adverse effects, and monitoring, noting that side effects are dose-dependent and include mucocutaneous issues, hepatotoxicity, and teratogenicity. Acitretin is contraindicated in pregnancy and requires careful patient selection and monitoring, especially in those with cardiovascular risk factors or metabolic syndrome. It is less effective than other systemic drugs but valuable for its long-term safety profile and lack of immunosuppression, achieving a PASI 75 response in 40% to 50% of patients. The document also acknowledges the authors' financial ties to the pharmaceutical industry related to antipsoriatic drugs.
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