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Oral Agents for Psoriasis

  • Kristen M. Beck
  • Eric J. Yang
  • Ladi Afifian
  • Di Yan
  • Tina Bhutani
Chapter
Part of the Updates in Clinical Dermatology book series (UCD)

Abstract

A variety of oral agents are part of the therapeutic armamentarium for the treatment of moderate-to-severe psoriasis. Types of oral agents that are used to treat psoriasis include cytotoxic and immunomodulatory drugs such as methotrexate, cyclosporine, and apremilast. Another oral agent, acitretin, is a systemic retinoid that affects epidermal proliferation and differentiation as well as immunomodulation. Oral agents for psoriasis are effective as monotherapy and may also be used in combination with other treatment modalities. Important factors to consider when selecting an oral agent include effectiveness, comorbid conditions, drug side effects, lifestyle considerations, risk factors, drug availability, patient preference, and financial cost of treatment. MTX, cyclosporine, and acitretin have long been used in the treatment of psoriasis for decades and require careful monitoring due to their generally unfavorable side effect profiles, whereas, apremilast, a much newer oral therapy, has far fewer adverse effects. This chapter will review the evidence for use of each of these oral agents in the treatment of psoriasis.

Keywords

Psoriasis Psoriasis treatment Systemic treatment Oral medications Methotrexate Acitretin Retinoids Cyclosporine Calcineurin inhibitors Apremilast PDE4 inhibitors 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kristen M. Beck
    • 1
  • Eric J. Yang
    • 2
  • Ladi Afifian
    • 1
  • Di Yan
    • 1
  • Tina Bhutani
    • 2
  1. 1.Department of DermatologyUCSF Medical CenterSan FranciscoUSA
  2. 2.Department of Dermatology, UCSF Psoriasis CenterUniversity of California San FranciscoSan FranciscoUSA

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