Advertisement

Traditional systemic therapy II: retinoids and others (hydroxyurea, thiopurine antimetabolites, mycophenlic acid, sulfasalazine)

  • Sejal K. Shah
  • Jeffrey M. Weinberg
Part of the Milestones in Drug Therapy book series (MDT)

Abstract

Many systemic agents are commonly used to treat generalized psoriasis. Although they are efficacious, their potential adverse effects require close monitoring. These agents can be used either alone or in combination therapy. In addition, they can be used as rotational or sequential therapies.

Keywords

Mycophenolate Mofetil Mycophenolic Acid Complete Blood Count TPMT Activity Pustular Psoriasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Napoli JL, Boerman MH, Chai X, Zhai Y, Fiorella PD (1995) Enzymes and binding proteins affecting retinoic acid concentrations. J Steroid Biochem Mol Biol 53: 497–502PubMedCrossRefGoogle Scholar
  2. 2.
    Napoli JL (1996) Retinoic acid biosynthesis and metabolism. FASEB J 10: 993–1001PubMedGoogle Scholar
  3. 3.
    Saurat JH (1999) Retinoids and psoriasis: novel issues in retinoid pharmacology and implications for psoriasis treatment. J Am Acad Dermatol 41: S2–6PubMedCrossRefGoogle Scholar
  4. 4.
    Torma H, Rollman O, Vahlquist A (1998) Interferon-g increases retinoic acid and 3,4-didehydroretinoic acid concentrations in cultured keratinocytes: a clue to the abnormal vitamin A metabolism in psoriatic skin. J Invest Dermatol 110: 551Google Scholar
  5. 5.
    Geiger JM, Saurat JH (1993) Acitretin and etretinate. How and when they should be used. Dermatol Clin 11: 117–129PubMedGoogle Scholar
  6. 6.
    Ling MR (1999) Acitretin: optimal dosing strategies. J Am Acad Dermatol 41: S13–17PubMedCrossRefGoogle Scholar
  7. 7.
    Soriatane package insert (2004) Palo Alto, CA: Connectics CorporationGoogle Scholar
  8. 8.
    Geiger JM, Czarnetzki BM (1988) Acitretin (Ro 10-1670, etretin): overall evaluation of clinical studies. Dermatologica 176: 182–190PubMedCrossRefGoogle Scholar
  9. 9.
    Camisa C (2004) Handbook of psoriasis. Publishing Ltd, Malden, MAGoogle Scholar
  10. 10.
    Lebwohl M, Ali S (2001) Treatment of psoriasis. Part 2. Systemic therapies. J Am Acad Dermatol 45: 649–661PubMedCrossRefGoogle Scholar
  11. 11.
    Roenigk HH (1999) Acitretin combination therapy. J Am Acad Dermatol 41: S18–21PubMedCrossRefGoogle Scholar
  12. 12.
    Katz HI, Waalen J, Leach EE (1999) Acitretin in psoriasis: an overview of adverse effects. J Am Acad Dermatol 41: S7–S12PubMedCrossRefGoogle Scholar
  13. 13.
    McNamara PJ, Jewell RC, Jensen BK, Brindley CJ (1988) Food increases the bioavailability of acitretin. J Clin Pharmacol 28: 1051–1055PubMedGoogle Scholar
  14. 14.
    Nguyen EQH (2001) Systemic retinoids. In: CL Kulp-Shorten, SE Wolverton (eds): Comprehensive dermatologic drug therapy. WB Saunders Company, Philadelphia (PA), 269–310Google Scholar
  15. 15.
    McClure SL, Valentine J, Gordon KB (2002) Comparative tolerability of systemic treatments for plaque-type psoriasis. Drug Saf 25: 913–927PubMedCrossRefGoogle Scholar
  16. 16.
    Roche Laboratories, data on fileGoogle Scholar
  17. 17.
    Gollnick HP (1996) Oral retinoids: efficacy and toxicity in psoriasis. Br J Dermatol 135Suppl 49: 6–17PubMedCrossRefGoogle Scholar
  18. 18.
    Wilson DJ, Kay V, Charig M, Hughes DG, Creasy TS (1988) Skeletal hyperostosis and extraosseous calcification in patients receiving long-term etretinate (Tigason). Br J Dermatol 119: 597–607PubMedCrossRefGoogle Scholar
  19. 19.
    Yarbro JW (1969) Hydroxyurea in the treatment of refractory psoriasis. Lancet 2: 846–847PubMedCrossRefGoogle Scholar
  20. 20.
    Leavell UW, Yarbro JW (1970) Hydroxyurea. A new treatment for psoriasis. Arch Dermatol 102: 144–150PubMedCrossRefGoogle Scholar
  21. 21.
    Yamauchi PS, Rizk D, Kormeili T, Patnail R, Lowe NJ (2003) Current systemic therapies for psoriasis: where are we now? J Am Acad Dermatol 49: S66–77PubMedCrossRefGoogle Scholar
  22. 22.
    Vogler WR, Bain JA, Huguley CM (1966) In vivo effect of hydroxyurea on orotic acid synthesis. Cancer Res 26: 1827–1831PubMedGoogle Scholar
  23. 23.
    Klem EB (1978) Effects of antipsoriasis drugs and metabolic inhibitors on the growth of epidermal cells in culture. J Invest Dermatol 70: 27–32PubMedCrossRefGoogle Scholar
  24. 24.
    Boyd AS, Neldner KH (1991) Hydroxyurea therapy. J Am Acad Dermatol 25: 518–524PubMedGoogle Scholar
  25. 25.
    Burns DA, Sarkany I, Gaylarde P (1980) Effects of hydroxyurea therapy on normal skin: a case report. Clin Exp Dermatol 5: 447–449PubMedCrossRefGoogle Scholar
  26. 26.
    Kennedy BJ, Smith LR, Goltx RW (1975) Skin changes secondary to hydroxyurea therapy. Arch Dermatol 111: 183–187PubMedCrossRefGoogle Scholar
  27. 27.
    Stein KM, Shelley WB, Weinberg RA (1971) Hydroxyurea in the treatment of pustular psoriasis. Br J Dermatol 85: 81–85PubMedGoogle Scholar
  28. 28.
    Wahba A, Cohen H, Bar-Eli M, Callily R (1979) Neutrophil chemotaxis in psoriasis. Acta Derm Venereol 59: 441–445PubMedGoogle Scholar
  29. 29.
    Moschella SL, Greenwald MA (1973) Psoriasis with hydroxyurea. An 18-month study of 60 patients. Arch Dermatol 107: 363–368PubMedCrossRefGoogle Scholar
  30. 30.
    Layton AM, Sheehan-Dare RA, Goodfield MJ, Cotterill JA (1989) Hydroxyurea in the management of therapy resistant psoriasis. Br J Dermatol 121: 647–653PubMedCrossRefGoogle Scholar
  31. 31.
    Kumar B, Saraswat A, Kaur I (2001) Rediscovering hydroxyurea: its role in recalcitrant psoriasis. Int J Dermatol 40: 530–534PubMedCrossRefGoogle Scholar
  32. 32.
    Hydrea package insert (2001) Princeton, NJ: Bristol-Myers Squibb CompanyGoogle Scholar
  33. 33.
    Kumar B, Saraswat A, Kaur I (2002) Mucocutaneous adverse effects of hydroxyurea: a prospective study of 30 psoriasis patients. Clin Exp Dermatol 27: 8–13PubMedCrossRefGoogle Scholar
  34. 34.
    Thurman WG, Bloedow C, Howe CD, Levin WC, Davis P, Lane M, Sullivan MP, Griffith KM (1963) A phase I study of hydroxyurea. Cancer Chemother Rep 29: 103–107PubMedGoogle Scholar
  35. 35.
    Folan DW (1977) Severe reaction to hydroxyurea. Cutis 20: 95PubMedGoogle Scholar
  36. 36.
    Heddle R, Calvert AF (1980) Hydroxyurea induced hepatitis. Med J Aust 1: 121PubMedGoogle Scholar
  37. 37.
    Baker H (1982) Antimitotic drugs in psoriasis. In: EM Farber, AJ Cox (eds): Psoriasis: Proceedings of the Third International Symposium. Grune and Stratton, New York, 119–126Google Scholar
  38. 38.
    Samuels ML, Howe CD (1964) Renal abnormalities induced by hydroxyurea (NSC-32065) Cancer Chemother Rep 40: 9–13PubMedGoogle Scholar
  39. 39.
    Snow JL, Gibson LE (1995) The role of genetic variation in thiopurine methyltransferase activity and the efficacy and/or side effects of azathioprine therapy in dermatologic patients. Arch Dermatol 131: 193–197PubMedCrossRefGoogle Scholar
  40. 40.
    Kazlow Stern D, Tripp JM, Ho VC, Lebwohl M (2005) The use of systemic immune moderators in dermatology: an update. Dermatol Clin 23: 259–300PubMedCrossRefGoogle Scholar
  41. 41.
    Sanderson J, Ansari A, Marinaki T, Duley J (2004) Thiopurine methyltransferase: should it be measured before commencing thiopurine drug therapy? Ann Clin Biochem 41: 294–302PubMedCrossRefGoogle Scholar
  42. 42.
    Patel AA, Swerlick RA, McCall CO (2006) Azathioprine in dermatology: the past, the present, and the future. J Am Acad Dermatol 55: 369–389PubMedCrossRefGoogle Scholar
  43. 43.
    35. Holme SA, Duley JA, Sanderson J, Routledge PA, Anstey AV (2002) Erythrocyte thiopurine methyl transferase assessment prior to azathioprine use in the UK. QJM 95: 439–444PubMedCrossRefGoogle Scholar
  44. 44.
    Weinshilboum RM, Sladek SL (1980) Mercaptopurine pharmacogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity. Am J Hum Genet 32: 651–662PubMedGoogle Scholar
  45. 45.
    du Vivier A, Munro DD, Verbov J (1974) Treatment of psoriasis with azathioprine. Br Med J 1: 49–51PubMedGoogle Scholar
  46. 46.
    Zackheim HS, Glogau RG, Fisher DA, Maibach HI (1994) 6-Thioguanine treatment of psoriasis: experience in 81 patients. J Am Acad Dermatol 30: 452–458PubMedGoogle Scholar
  47. 47.
    Mason C, Krueger GG (2001) Thioguanine for refractory psoriasis: a 4-year experience. J Am Acad Dermatol 44: 67–72PubMedCrossRefGoogle Scholar
  48. 48.
    Anstey AV, Wakelin S, Reynolds NJ (2004) Guidelines for prescribing azathioprine in dermatology. Br J Dermatol 151: 1123–1132PubMedCrossRefGoogle Scholar
  49. 49.
    Tabloid package insert (2004) Research Triangle Park, NC: GlaxoSmithKlineGoogle Scholar
  50. 50.
    Silvis NG, Levine N (1999) Pulse dosing of thioguanine in recalcitrant psoriasis. Arch Dermatol 135: 433–437PubMedCrossRefGoogle Scholar
  51. 51.
    Imuran package insert (2001) San Diego, CA: Prometheus Laboratories, Inc.Google Scholar
  52. 52.
    Kao NL, Rosenblate HJ (1993) 6-Thioguanine therapy for psoriasis causing toxic hepatic venoocclusive disease. J Am Acad Dermatol 28: 1017–1018PubMedCrossRefGoogle Scholar
  53. 53.
    de Boer NK, Jarbandhan SV, de Graaf P, Mulder CJ, van Elburg RM, van Bodegraven AA (2006) Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites. Am J Gastroenterol 101: 1390–1392PubMedCrossRefGoogle Scholar
  54. 54.
    de Boer NK, van Elburg RM, Wilhelm AJ, Remmink AJ, van Vugt JM, Mulder CJ, van Bodegraven AA (2005) 6-Thioguanine for Crohn’s disease during pregnancy: thiopurine metabolite measurements in both mother and child. Scand J Gastroenterol 40: 1374–1377PubMedCrossRefGoogle Scholar
  55. 55.
    Norgard B, Pedersen L, Jacobsen J, Rasmussen SN, Sorensen HT (2004) The risk of congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine before conception. Aliment Pharmacol Ther 19: 679–685PubMedCrossRefGoogle Scholar
  56. 56.
    Rajapakse RO, Korelitz BI, Zlatanic J, Baiocco PJ, Gleim GW (2000) Outcome of pregnancies when fathers are treated with 6-mercaptopurine for inflammatory bowel disease. Am J Gastroenterol 95: 684–688PubMedCrossRefGoogle Scholar
  57. 57.
    Allison AC, Eugui EM (1996) Purine metabolism and immunosuppressive effects if mycophenolate mofetil (MMF). Clin Transplant 10: 77–84PubMedGoogle Scholar
  58. 58.
    Geilen CC, Arnold M, Orfanos CE (2001) Mycophenolic mofetil as a systemic antipsoriatic agent: positive experience in 11 patients. Br J Dermatol 144: 583–586PubMedCrossRefGoogle Scholar
  59. 59.
    Kitchin JE, Pomeranz MK, Pak G, Washenik K, Shupack JL (1997) Rediscovering mycophenolic acid: a review of its mechanism, side effects, and potential uses. J Am Acad Dermatol 37: 445–449PubMedCrossRefGoogle Scholar
  60. 60.
    Jones EL, Epinette WW, Hackney VC, Menendez L, Frost P (1975) Treatment of psoriasis with oral mycophenolic acid. J Invest Dermatol 65: 537–542PubMedCrossRefGoogle Scholar
  61. 61.
    Lynch WS, Roenigk HH (1977) Mycophenolic acid for psoriasis. Arch Dermatol 113: 1203–1208PubMedCrossRefGoogle Scholar
  62. 62.
    Marinari R, Fleischmajer R, Schragger AH, Rosenthal AL (1977) Mycophenolic acid in the treatment of psoriasis: long-term administration. Arch Dermatol 113: 930–932PubMedCrossRefGoogle Scholar
  63. 63.
    Gomez EC, Menendez L, Frost P (1979) Efficacy of mycophenolic acid for the treatment of psoriasis. J Am Acad Dermatol 1: 531–537PubMedGoogle Scholar
  64. 64.
    Epinette WW, Parker CM, Jones EL, Greist MC (1987) Mycophenolic acid for psoriasis. A review of pharmacology, long-term efficacy, and safety. J Am Acad Dermatol 17: 962–971PubMedCrossRefGoogle Scholar
  65. 65.
    Haufs MG, Beissert S, Grabbe S, Schutte B, Luger TA (1998) Psoriasis vulgaris treated successfully with mycophenolate mofetil. Br J Dermatol 138: 179–181PubMedCrossRefGoogle Scholar
  66. 66.
    Zhou Y, Rosenthal D, Dutz J, Ho V (2003) Mycophenolate mofetil (CellCept) for psoriasis: a twocenter, prospective, open-label clinical trial. J Cutan Med Surg 7: 193–197PubMedCrossRefGoogle Scholar
  67. 67.
    CellCept package insert (2005) Nutley, NJ: Roche LaboratoriesGoogle Scholar
  68. 68.
    Myfortic package insert (2004) East Hanover, NJ: Novartis Pharmaceuticals CorporationGoogle Scholar
  69. 69.
    Mathew TH (1998) A blinded, long-term, randomized multicenter study of mycophenolate mofetil in cadaveric renal transplantation: results at three years. Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group. Transplantation 65: 1450–1454PubMedCrossRefGoogle Scholar
  70. 70.
    Platz KP, Sollinger HW, Hullett DA, Eckhoff DE, Eugui EM, Allison AC (1991) RS-61443 — a new, potent immunosuppressive agent. Transplantation 51: 27–31PubMedCrossRefGoogle Scholar
  71. 71.
    Ensley RD, Bristow MR, Olsen SL, Taylor DO, Hammond DH, O’Connell JB, Dunn D, Osburn L, Jones KW, Kauffman RS et al. (1993) The use of mycophenolate mofetil (RS-61443) in human heart transplant recipients. Transplantation 56: 75–82PubMedCrossRefGoogle Scholar
  72. 72.
    Goldblum R (1993) Therapy of rheumatoid arthritis with mycophenolate mofetil. Clin Exper Rheum 11: S117–119Google Scholar
  73. 73.
    Cohen HD, Das KM (2006) The metabolism of mesalamine and its possible use in colonic diver ticulitis as an anti-inflammatory agent. J Clin Gastroenterol 40: S150–154PubMedCrossRefGoogle Scholar
  74. 74.
    Gupta AK, Ellis CN, Siegel MT, Duell EA, Griffiths CE, Hamilton TA, Nickoloff BJ, Voorhees JJ (1990) Sulfasalazine improves psoriasis. A double-blind analysis. Arch Dermatol 126: 487–493PubMedCrossRefGoogle Scholar
  75. 75.
    Gupta AK, Ellis CN, Siegel MT, Voorhees JJ (1989) Sulfasalazine: a potential psoriasis therapy? J Am Acad Dermatol 20: 797–800PubMedCrossRefGoogle Scholar
  76. 76.
    Schoch EP, McCuistion CH (1955) The effect of salicylazosulfapyridine (azulfidine) on pustular acne vulgaris and certain other dermatoses. J Invest Dermatol 25: 123–126PubMedGoogle Scholar
  77. 77.
    Lorincz AL, Pearson RW (1962) Sulfapyridine and sulfone type drugs in dermatology. Arch Dermatol 85: 2–16PubMedGoogle Scholar
  78. 78.
    Azulfidine package insert (2002) Kalamazoo, MI: Pharmacia CorporationGoogle Scholar
  79. 79.
    Lebwohl M (1999) Acitretin in combination with UVB or PUVA. J Am Acad Dermatol 41: S22–24PubMedCrossRefGoogle Scholar
  80. 80.
    Weinstein GD, White GM (1993) An approach to the treatment of moderate to severe psoriasis with rotational therapy. J Am Acad Dermatol 28: 454–459PubMedGoogle Scholar
  81. 81.
    Koo J (1999) Systemic sequential therapy of psoriasis: a new paradigm for improved therapeutic results. J Am Acad Dermatol 41: S25–28PubMedCrossRefGoogle Scholar

Copyright information

© Birkhäuser Verlag/Switzerland 2008

Authors and Affiliations

  • Sejal K. Shah
    • 1
  • Jeffrey M. Weinberg
    • 1
  1. 1.Department of DermatologySt. Luke’s-Roosevelt Hospital CenterNew YorkUSA

Personalised recommendations