Guidelines for the use of acitretin in psoriasis. Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Actas Dermosifiliogr. 2013 Sep;104(7):598-616. doi: 10.1016/j.adengl.2013.01.001. Epub 2013 Jul 23.

Abstract

Phototherapy, classic systemic treatments (methotrexate, acitretin, and ciclosporin), and biologic agents (etanercept, infliximab, adalimumab, and ustekinumab) constitute a broad therapeutic arsenal that increases the likelihood of achieving control of severe and extensive disease in patients with psoriasis. Acitretin continues to be a very valuable tool in both monotherapy, in which it is combined with other systemic treatments (classic or biologic), and in sequential therapy. Thanks to its lack of a direct immunosuppressive effect and its ability to achieve a long-term response, acitretin has an important role in the treatment of psoriasis, although this has not always been acknowledged in relevant treatment guidelines. We present consensus guidelines for the use of acitretin in psoriasis drawn up by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. These guidelines provide a detailed account of acitretin, including pharmacological properties, indications and contraindications, adverse effects, and factors that should be taken into account to enhance the safe use of this drug. They also propose treatment strategies for use in routine clinical practice. The overall aim of these guidelines is to define the criteria for the use and management of acetretin in psoriasis.

Keywords: Acitretin; Acitretina; Antipsoriasis systemic treatment; Guidelines; Guía; Psoriasis; Tratamiento; Tratamiento sistémico antipsoriásico; Treatment.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Abnormalities, Drug-Induced / etiology
  • Acitretin / administration & dosage
  • Acitretin / adverse effects
  • Acitretin / pharmacokinetics
  • Acitretin / therapeutic use*
  • Biotransformation
  • Cardiovascular Diseases / complications
  • Comorbidity
  • Contraindications
  • Drug Administration Schedule
  • Drug Interactions
  • Female
  • Gene Expression Regulation / drug effects
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacokinetics
  • Immunosuppressive Agents / therapeutic use*
  • Keratinocytes / drug effects
  • Keratinocytes / pathology
  • Metabolic Syndrome / complications
  • Pregnancy
  • Pregnancy Complications
  • Psoriasis / complications
  • Psoriasis / drug therapy*
  • Psoriasis / genetics
  • Receptors, Retinoic Acid / agonists
  • Risk Assessment
  • Tetracyclines / pharmacokinetics

Substances

  • Immunosuppressive Agents
  • Receptors, Retinoic Acid
  • Tetracyclines
  • Acitretin