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Systemic Therapies in Psoriasis

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Biologic and Systemic Agents in Dermatology

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Abstract

Psoriasis is a chronic inflammatory skin disease with a significant negative impact on a patient’s self-esteem, work productivity, quality of life, and indeed pocketbook [1–4]. Moderate-to-severe psoriasis has also been associated with multiple comorbidities including the metabolic syndrome, cardiovascular disease, depression, and psoriatic arthritis [5–9] (Fig. 16.1). For patients with moderate-to-severe psoriasis (>10% body surface area involvement), conventional systemic therapies can offer an effective, cost-effective, well-tolerated alternative treatment to topical treatments, light therapy, as well as the full spectrum of biologic agents [10].

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References

  1. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–6.

    Article  PubMed  Google Scholar 

  2. Feldman SR, Malakouti M, Koo JY. Social impact of the burden of psoriasis: effects on patients and practice. Dermatol Online J. 2014;20(8.) pii: 13030/qt48r4w8h2

    Google Scholar 

  3. Fowler JF, Duh MS, Rovba L, et al. The impact of psoriasis on health care costs and patient work loss. J Am Acad Dermatol. 2008;59(5):772–80.

    Article  PubMed  Google Scholar 

  4. Edson-Heredia E, Zhu B, Guo J, Maeda-Chubachi T, Lebwohl M. Disease burden and quality of life in psoriasis patients with and without comorbid psoriatic arthritis: results from National Psoriasis Foundation panel surveys. Cutis. 2015;95(3):173–8.

    PubMed  Google Scholar 

  5. Gisondi P, Galvan A, Idolazzi L, Girolomoni G. Management of moderate to severe psoriasis in patients with metabolic comorbidities. Front Med (Lausanne). 2015;2:1.

    Google Scholar 

  6. Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2:e54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Menter A, Gottlieb G, Steven R, Van Voorhees AS, Leonardi CL, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58:826–50.

    Article  PubMed  Google Scholar 

  8. Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc. 2013;2(2):e000062. https://doi.org/10.1161/JAHA.113.000062.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ogdie A, Yu YD, Haynes K, Love TJ, Maliha S, Jiang Y, Troxel AB, Hennessy S, Kimmel SE, Margolis DJ, Choi H, Mehta NN, Gelfand JM. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015;74(2):326–32.

    Article  PubMed  Google Scholar 

  10. Rustin MHA. Long-term safety of biologics in the treatment of moderate-to-severe plaque psoriasis: review of current data. Br J Dermatol. 2012;167(Suppl 3):3–11.

    Article  CAS  PubMed  Google Scholar 

  11. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85.

    Article  CAS  PubMed  Google Scholar 

  12. Gupta AK, Baadsgaard O, Ellis CN, Voorhees JJ, Cooper KD. Lymphocytes and macrophages of the epidermis and dermis in lesional psoriatic skin, but no epidermal Langerhans cells, are depleted by treatment with cyclosporine A. Arch Dermatol Res. 1989;281:219–26.

    Article  CAS  PubMed  Google Scholar 

  13. Gottlieb AB, Grossman RM, Khandke L, Carter DM, Sehgal PB, Fu SM, et al. Studies of the effect of cyclosporine in psoriasis in vivo: combined effects on activated T lymphocytes and epidermal regenerative maturation. J Invest Dermatol. 1992;98:302–9.

    Article  CAS  PubMed  Google Scholar 

  14. Prens EP, van Joost T, Hegmans JP, t Hooft-Benne K, Ysselmuiden OE, Benner R. Effects of cyclosporine on cytokines and cytokine receptors in psoriasis. J Am Acad Dermatol. 1995;33:947–53.

    Article  CAS  PubMed  Google Scholar 

  15. Taler SJ, Textor SC, Canzanello VJ, Schwartz L. Cyclosporin induced hypertension: incidence, pathogenesis and management. Drug Saf. 1999;20:437–49.

    Article  CAS  PubMed  Google Scholar 

  16. Lowe NJ, Wieder JM, Rosenbach A, Johnson K, Kunkel R, Bainbridge C, et al. Long-term low-dose cyclosporine therapy for severe psoriasis: effects on renal function and structure. J Am Acad Dermatol. 1996;35:710–9.

    Article  CAS  PubMed  Google Scholar 

  17. Markham T, Watson A, Rogers S. Adverse effects with long term cyclosporin for severe psoriasis. Clin Exp Dermatol. 2002;27:111–4.

    Article  PubMed  Google Scholar 

  18. Powles AV, Hardman CM, Porter WM, Cook T, Hulme B, Fry L. Renal function after 10 years’ treatment with cyclosporin for psoriasis. Br J Dermatol. 1998;138:443–9.

    Article  CAS  PubMed  Google Scholar 

  19. Ryan C, Amor KT, Menter A. The use of cyclosporine in dermatology: Part II. J Am Acad Dermatol. 2010;63(6):949–72.

    Article  CAS  PubMed  Google Scholar 

  20. Young EW, Ellis CN, Messana JM, Johnson KH, Leichtman AB, Mihatsch MJ, et al. A prospective study of renal structure and function in psoriasis patients treated with cyclosporin. Kidney Int. 1994;46:1216–22.

    Article  CAS  PubMed  Google Scholar 

  21. Zachariae H, Kragballe K, Hansen HE, Marcussen N, Olsen S. Renal biopsy findings in long-term cyclosporin treatment of psoriasis. Br J Dermatol. 1997;136:531–5.

    Article  CAS  PubMed  Google Scholar 

  22. Tomlanovich S, Gobletz H, Periroth M, Stinson E, Myers BD. Limitations of creatinine in quantifying the severity of cyclosporine-induced nephropathy. Am J Kidney Dis. 1986;8:332–3.

    Article  CAS  PubMed  Google Scholar 

  23. Feutren G, Abeywickrama K, Friend D, Von Graffenried B. Renal function and blood pressure in psoriatic patients treated with cyclosporin A. Br J Dermatol. 1990;122(Suppl 36):57–69.

    Article  PubMed  Google Scholar 

  24. Lebwohl M, Ellis C, Gottlieb A, Koo J, Krueger G, Linden K, et al. Cyclosporine consensus conference: with emphasis on the treatment of psoriasis. J Am Acad Dermatol. 1998;39:464–75.

    Article  CAS  PubMed  Google Scholar 

  25. Berth-Jones J, Henderson CA, Munro CS, Rogers S, Chalmers RJ, Boffa MJ, et al. Treatment ofpsoriasis with intermittent short course cyclosporin (Neoral): a multicenter study. Br J Dermatol. 1997;136:527–30.

    Article  CAS  PubMed  Google Scholar 

  26. Ellis CN, Fradin MS, Messana JM, Brown MD, Siegel MT, Hartley AH, et al. Cyclosporine for plaque-type psoriasis: results of a multidose, double-blind trial. N Engl J Med. 1991;324:277–84.

    Article  CAS  PubMed  Google Scholar 

  27. Faerber L, Braeutigam M, Weidinger G, Mrowietz U, Christophers E, Schulze HJ, et al. Cyclosporine in severe psoriasis: results of a meta-analysis in 579 patients. Am J Clin Dermatol. 2001;2:41–7.

    Article  CAS  PubMed  Google Scholar 

  28. Ho VC, Griffiths CE, Albrecht G, Vanaclocha F, Leon-Dorantes G, Atakan N, et al. Intermittent short courses of cyclosporin (Neoral(R)) for psoriasis unresponsive to topical therapy: a 1-year multicenter, randomized study. The PISCES Study Group. Br J Dermatol. 1999;141:283–91.

    Article  CAS  PubMed  Google Scholar 

  29. Ho VC, Griffiths CE, Berth-Jones J, Papp KA, Vanaclocha F, Dauden E, et al. Intermittent short courses of cyclosporine microemulsion for the long-term management of psoriasis: a 2-year cohort study. J Am Acad Dermatol. 2001;44:643–51.

    Article  CAS  PubMed  Google Scholar 

  30. Nast A, Kopp I, Augustin M, Banditt KB, Boehncke WH, Follmann M, et al. German evidence-based guidelines for the treatment of psoriasis vulgaris (short version). Arch Dermatol Res. 2007;299:111–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Gilbert SC, Emmett M, Menter A, Silverman A, Klintmalm G. Cyclosporine therapy for psoriasis: serum creatinine measurements are an unreliable predictor of decreased renal function. J Am Acad Dermatol. 1989;21:470–4.

    Article  CAS  PubMed  Google Scholar 

  32. Ternowitz T, Herlin T. Neutrophil and monocyte chemotaxis in methotrexate-treated psoriasis patients. Acta Derm Venereol Suppl (Stockh). 1985;120:23–6.

    CAS  Google Scholar 

  33. Jeffes EW III, McCullough JL, Pittelkow MR, McCormick A, Almanzor J, Liu G, et al. Methotrexate therapy of psoriasis: differential sensitivity of proliferating lymphoid and epithelial cells to the cytotoxic and growth-inhibitory effects of methotrexate. J Invest Dermatol. 1995;104:183–8.

    Article  PubMed  Google Scholar 

  34. Saporito FC, Menter MA. Methotrexate and psoriasis in the era of new biologic agents. J Am Acad Dermatol. 2004;50:301–9.

    Article  PubMed  Google Scholar 

  35. Dogra S, Mahajan R. Systemic methotrexate therapy for psoriasis: past, present and future. Clin Exp Dermatol. 2013;38:573–88.

    Article  CAS  PubMed  Google Scholar 

  36. MacDonald A, Burden AD. Noninvasive monitoring for methotrexate hepatotoxicity. Br J Dermatol. 2005;152:405–8.

    Article  CAS  PubMed  Google Scholar 

  37. Montaudié H, Sbidian E, Paul C, Maza A, Gallini A, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Ortonne J-P. Methotrexate in psoriasis: a systematic review of treatment modalities, incidence, risk factors and monitoring of liver toxicity. J Eur Acad Dermatol Venereol. 2011;25:12–8.

    Article  PubMed  CAS  Google Scholar 

  38. Langman G, Hall PM, Todd G. Role of non-alcoholic steatohepatitis in methotrexate-induced liver injury. J Gastroenterol Hepatol. 2001;16:1395–401.

    Article  CAS  PubMed  Google Scholar 

  39. Rosenberg P, Urwitz H, Johannesson A, Ros AM, Lindholm J, Kinnman N, et al. Psoriasis patients with diabetes type 2 are at high risk of developing liver fibrosis during methotrexate treatment. J Hepatol. 2007;46:1111–8.

    Article  CAS  PubMed  Google Scholar 

  40. Strober BE, Menon K. Folate supplementation during methotrexate therapy for patients with psoriasis. J Am Acad Dermatol. 2005;53:652–9.

    Article  PubMed  Google Scholar 

  41. Kalb RE, Strober B, Weinstein G, Lebwohl M. Methotrexate and psoriasis: 2009 National Psoriasis Foundation consensus conference. J Am Acad Dermatol. 2009;60:824–37.

    Article  PubMed  Google Scholar 

  42. Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs methotrexate vs placebo in patients with psoriasis (CHAMPION). Br J Dermatol. 2008;158:558–66.

    Article  CAS  PubMed  Google Scholar 

  43. Barker J, Hoffmann M, Wozel G, et al. Efficacy and safety of infliximab vs. methotrexate in patients with moderate-to-severe plaque psoriasis: results of an open-label, active-controlled, randomized trial (RESTORE1). Br J Dermatol. 2011;165:1109–17.

    Article  CAS  PubMed  Google Scholar 

  44. Atzeni F, Sarzi-Puttini P. Autoantibody production in patients treated with anti-TNF. Expert Rev Clin Immunol. 2008;4:275–80.

    Article  CAS  PubMed  Google Scholar 

  45. Buccheri L, Katchen BR, Kart AJ, Her J, Cohen SR. Acitretin therapy is effective for psoriasis associated with human immunodeficiency virus infection. Arch Dermatol. 1997;133:711–5.

    Article  CAS  PubMed  Google Scholar 

  46. Katz HI, Waalen J, Leach EE. Acitretin in psoriasis: an overview of adverse effects. J Am Acad Dermatol. 1999;41:S7–S12.

    Article  CAS  PubMed  Google Scholar 

  47. Yamauchi PS, Rizk D, Kormeili T, et al. Current systemic therapies for psoriasis: where are we now? J Am Acad Dermatol. 2003;49:S66–77.

    Article  PubMed  Google Scholar 

  48. Allison AC, Eugui EM. Purine metabolism and immunosuppressive effects of mycophenolate mofetil (MMF). Clin Transplant. 1996;10(1 Pt 2):77–84.

    CAS  PubMed  Google Scholar 

  49. Geilen CC, Arnold M, Orfanos CE. Mycophenolate mofetil as a systemic antipsoriatic agent: positive experience in 11 patients. Br J Dermatol. 2001;144(3):583–6.

    Article  CAS  PubMed  Google Scholar 

  50. Zhou Y, Rosenthal D, Dutz J, Ho V. Mycophenolate mofetil (CellCept(R)) for psoriasis: a two-center, prospective, open-label clinical trial. J Cutan Med Surg. 2003;7:193–7.

    Article  PubMed  Google Scholar 

  51. Orvis AK, Wesson SK, Breza TS, Church AA, Mitchell CL, Watkins SW. Mycophenolate mofetil in dermatology. J Am Acad Dermatol. 2009;60:183–99.

    Article  PubMed  Google Scholar 

  52. Assmann T, Ruzicka T. New immunosuppressive drugs in dermatology (mycophenolate mofetil, tacrolimus): unapproved uses, dosages, or indications. Clin Dermatol. 2002;20(5):505–14.

    Article  PubMed  Google Scholar 

  53. Du Vivier A, Munro DD, Verbov J. Treatment of psoriasis with azathioprine. Br Med J. 1974;1:49–51.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Greaves MW, Dawber R. Azathioprine in psoriasis. Br Med J. 1970;2:237–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Snow JL, Gibson LE. The role of genetic variation in thiopurine methyltransferase activity and the efficacy and/or side effects of azathioprine therapy in dermatologic patients. Arch Dermatol. 1995;131:193–7.

    Article  CAS  PubMed  Google Scholar 

  56. Roll A, Reich K, Boer A. Use of fumaric acid esters in psoriasis. Indian J Dermatol Venereol Leprol. 2007;73:133–7.

    Article  PubMed  Google Scholar 

  57. Mrowietz U, Christophers E, Altmeyer F. Treatment of severe psoriasis with fumaric acid esters: scientific background and guidelines for therapeutic use. The German Fumaric Acid Ester Consensus Conference. Br J Dermatol. 1999;141:424–9.

    Article  CAS  PubMed  Google Scholar 

  58. Mrowietz U, Christophers E, Altmeyer P. Treatment of psoriasis with fumaric acid esters: results of a prospective multicenter study; German multicenter study. Br J Dermatol. 1998;138:456–60.

    Article  CAS  PubMed  Google Scholar 

  59. Altmeyer P, Hartwig R, Matthes U. Efficacy and safety profile of fumaric acid esters in oral long-term therapy with severe treatment refractory psoriasis vulgaris. A study of 83 patients. Hautarzt. 1996;47(3):190–6.

    Article  CAS  PubMed  Google Scholar 

  60. Smith D. Fumaric acid esters for psoriasis: a systematic review. Ir J Med Sci. 2017;186(1):161–77.

    Article  CAS  PubMed  Google Scholar 

  61. Altmeyer PJ, Matthes U, Pawlak F, et al. Antipsoriatic effect of fumaric acid derivatives. Results of a multicenter double-blind study in 100 patients. J Am Acad Dermatol. 1994;30(6):977–81.

    Article  CAS  PubMed  Google Scholar 

  62. Nieboer C, de Hoop D, Langendijk PN, van Loenen AC, Gubbels J. Fumaric acid therapy in psoriasis: a double-blind comparison between fumaric acid compound therapy and monotherapy with dimethylfumaric acid ester. Dermatologica. 1990;181(1):33–7.

    Article  CAS  PubMed  Google Scholar 

  63. Fallah Arani S, Neumann H, Hop WC, Thio HB. Fumarates vs methotrexate in moderate to severe chronic plaque psoriasis: a multicentre prospective randomized controlled clinical trial. Br J Dermatol. 2011;164(4):855–61.

    Article  CAS  PubMed  Google Scholar 

  64. Gollnick H, Altmeyer P, Kaufmann R, et al. Topical calcipotriol plus oral fumaric acid is more effective and faster acting than oral fumaric acid monotherapy in the treatment of severe chronic plaque psoriasis vulgaris. Dermatology. 2002;205(1):46–53.

    Article  CAS  PubMed  Google Scholar 

  65. Balak DM, Fallah-Arani S, Venema CM, Neumann HA, Thio HB. Addition of an oral histamine antagonist to reduce adverse events associated with fumaric acid esters in the treatment of psoriasis: a randomized double-blind placebo-controlled trial. Br J Dermatol. 2015;172(3):754–9. https://doi.org/10.1111/bjd.13277. Epub 2016 Jan 18

    Article  CAS  PubMed  Google Scholar 

  66. Mrowietz U, Asadullah K. Dimethylfumarate for psoriasis: more than a dietary curiosity. Trends Mol Med. 2005;11:43–8.

    Article  CAS  PubMed  Google Scholar 

  67. Harries MJ, Chalmers RJ, Griffiths CE. Fumaric acid esters for severe psoriasis: a retrospective review of 58 cases. Br J Dermatol. 2005;153(3):549–51.

    Article  CAS  PubMed  Google Scholar 

  68. Kolbach DN, Nieboer C. Fumaric acid therapy in psoriasis: results and side effects of 2 years of treatment. J Am Acad Dermatol. 1992;27:769–71.

    Article  CAS  PubMed  Google Scholar 

  69. Layton AM, Sheehan-Dare RA, Goodfield MJ, Cotterill JA. Hydroxyurea in the management of therapy resistant psoriasis. Br J Dermatol. 1989;121:647–53.

    Article  CAS  PubMed  Google Scholar 

  70. Ranjan N, Sharma NL, Shanker V, Mahajan VK, Tegta GR. Methotrexate versus hydroxycarbamide (hydroxyurea) as a weekly dose to treat moderate-to-severe chronic plaque psoriasis: a comparative study. J Dermatolog Treat. 2007;18:295–300.

    Article  CAS  PubMed  Google Scholar 

  71. Kumar B, Saraswat A, Kaur I. Rediscovering hydroxyurea: its role in recalcitrant psoriasis. Int J Dermatol. 2001;40:530–4.

    Article  CAS  PubMed  Google Scholar 

  72. Sharma VK, Dutta B, Ramam M. Hydroxyurea as an alternative therapy for psoriasis. Indian J Dermatol Venereol Leprol. 2004;70:13–7.

    PubMed  Google Scholar 

  73. Smith CH. Use of hydroxyurea in psoriasis. Clin Exp Dermatol. 1999;24:2–6.

    Article  CAS  PubMed  Google Scholar 

  74. Frieling U, Luger TA. Mycophenolate mofetil and leflunomide: promising compounds for the treatment of skin diseases. Clin Exp Dermatol. 2002;27(7):562–70.

    Article  CAS  PubMed  Google Scholar 

  75. Wozel G, Pfeiffer C. Leflunomide: a novel drug for pharmacological immunomodulation. Hautarzt. 2002;53(5):309–15.

    Article  CAS  PubMed  Google Scholar 

  76. Kaltwasser JP, Nash P, Gladman D, Rosen CF, Behrens F, Jones P, et al. Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: a multinational, double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum. 2004;50:1939–50.

    Article  CAS  PubMed  Google Scholar 

  77. Prakash A, Jarvis B. Leflunomide: a review of its use in active rheumatoid arthritis. Drugs. 1999;58:1137–64.

    Article  CAS  PubMed  Google Scholar 

  78. Nguyen M, Kabir M, Ravaud P. Short-term efficacy and safety of leflunomide in the treatment of active rheumatoid arthritis in everyday clinical use: open-label, prospective study. Clin Drug Investig. 2004;24(2):103–12.

    Article  CAS  PubMed  Google Scholar 

  79. Gupta AK, Ellis CN, Siegel MT, Duell EA, Griffiths CE, Hamilton TA, et al. Sulfasalazine improves psoriasis: a double-blind analysis. Arch Dermatol. 1990;126:487–93.

    Article  CAS  PubMed  Google Scholar 

  80. Watkinson G. Sulphasalazine: a review of 40 years’ experience. Drugs. 1986;32(Suppl 1):1–11.

    Article  PubMed  Google Scholar 

  81. Bos JD, Witkamp L, Zonnevald IM, Ruzicka T, Szarmach H, Szczerkowska-Dobosz A. Systemic tacrolimus (FK 506) is effective for the treatment of psoriasis in a double-blind, placebo-controlled study: the European FK 506 multicenter psoriasis study group. Arch Dermatol. 1996;132:419–23.

    Article  Google Scholar 

  82. Zackheim HS, Maibach HI. Treatment of psoriasis with 6-thioguanine. Australas J Dermatol. 1988;29:163–7.

    Article  CAS  PubMed  Google Scholar 

  83. Zackheim HS, Glogau RG, Fisher DA, Maibach HI. 6-Thioguanine treatment of psoriasis: experience in 81 patients. J Am Acad Dermatol. 1994;30:452–8.

    Article  CAS  PubMed  Google Scholar 

  84. Silvis NG, Levine N. Pulse dosing of thioguanine in recalcitrant psoriasis. Arch Dermatol. 1999;135:433–7.

    Article  CAS  PubMed  Google Scholar 

  85. Duong R, Gilbert M. Psoriasis: overview, recent approvals, therapies on the horizon. Pharmacy Today. 2016;22(1):44–5.

    Article  Google Scholar 

  86. Schafer P. Apremilast mechanism of action and application to psoriasis and psoriatic arthritis. Biochem Pharmacol. 2012;83:1583–90.

    Article  CAS  PubMed  Google Scholar 

  87. Papp K, Reich K, Leonardi CL, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM]1). J Am Acad Dermatol. 2015;73(1):37–49.

    Article  CAS  PubMed  Google Scholar 

  88. Paul C, et al. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized, controlled trial (ESTEEM 2). Br J Dermatol. 2015;173(6):1387–99.

    Article  CAS  PubMed  Google Scholar 

  89. Cauli A, Porru G, Piga M, Vacca A, Dessole G, Mathieu A. Clinical potential of apremilast in the treatment of psoriatic arthritis. Immunotargets Ther. 2014;3:91–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  90. Barker J, Horn EJ, Lebwohl M, et al. Assessment and management of methotrexate hepatotoxicity in psoriasis patients: report from a consensus conference to evaluate current practice and identify key questions toward optimizing methotrexate use in the clinic. J Eur Acad Dermatol Venereol. 2011;25(7):758–64.

    Article  CAS  PubMed  Google Scholar 

  91. Murray HE, Anhalt AW, Lessard R, Schacter RK, Ross JB, Stewart WD. A 12-month treatment of severe psoriasis with acitretin: Results of a Canadian open multicentre trial. J Am Acad Dermatol. 1991;24:598–602.

    Article  CAS  PubMed  Google Scholar 

  92. Lassus A, Geiger JM. Acitretin and etretinate in the treatment of palmoplantar pustulosis. A double-blind comparative trial. Br J Dermatol. 1988;119:755–9.

    Article  CAS  PubMed  Google Scholar 

  93. Katugampola RP, Finlay AY. Oral retinoids therapy for disorders of keratinization: A single-centre retrospective 25 years’ experience on 23 patients. Br J Dermatol. 2006;154:267–76.

    Article  CAS  PubMed  Google Scholar 

  94. Spuls PI, et al. J Dermatolog Treat. 2003;14(Suppl 2):17–20.

    Article  CAS  PubMed  Google Scholar 

  95. Barker JN. Methotrexate or fumarates: which is the best oral treatment for psoriasis? Br J Dermatol. 2011;164(4):695.

    Article  CAS  PubMed  Google Scholar 

  96. Heydendael VM, Spuls PI, Opmeer BC, et al. Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis. N Engl J Med. 2003;349(7):658–65.

    Article  CAS  PubMed  Google Scholar 

  97. Pedraz J, Daudén E, Delgado-jiménez Y, et al. Sequential study on the treatment of moderate-to-severe chronic plaque psoriasis with mycophenolate mofetil and cyclosporin. J Eur Acad Dermatol Venereol. 2006;20(6):702–6.

    Article  CAS  PubMed  Google Scholar 

  98. Rahman P, Gladman DD, Cook RJ, Zhou Y, Young G. The use of sulfasalazine in psoriatic arthritis: a clinic experience. J Rheumatol. 1998;25(10):1957–61.

    CAS  PubMed  Google Scholar 

  99. https://www.aad.org/practice-tools/quality-care/clinical-guidelines/psoriasis/systemic-agents/recommendations-for-methotrexate.

  100. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85.

    Article  CAS  PubMed  Google Scholar 

  101. Raposo I, Torres T. Palmoplantar psoriasis and palmoplantar pustulosis: current treatment and future prospects. Am J Clin Dermatol. 2016;17(4):349–58.

    Article  PubMed  Google Scholar 

  102. Spuls PI, et al. J Dermatolog Treat. 2003;14(Suppl 2):17–20.

    Article  CAS  PubMed  Google Scholar 

  103. Chiricozzi A, Panduri S, Dini V, Tonini A, Gualtieri B, Romanelli M. Optimizing acitretin use in patients with plaque psoriasis. Dermatol Ther. 2017;30(2). https://doi.org/10.1111/dth.12453. Epub 2016 Dec 20

  104. Valenzuela F, Paul C, Mallbris L, et al. Tofacitinib versus etanercept or placebo in patients with moderate to severe chronic plaque psoriasis: patient-reported outcomes from a Phase 3 study. J Eur Acad Dermatol Venereol. 2016;30(10):1753–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Papp KA, Menter MA, Abe M, et al. Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials. Br J Dermatol. 2015;173(4):949–61.

    Article  CAS  PubMed  Google Scholar 

  106. Menter A, Thrash B, Cherian C, et al. Intestinal transport of aminopterin enantiomers in dogs and humans with psoriasis is stereoselective: evidence for a mechanism involving the proton-coupled folate transporter. J Pharmacol Exp Ther. 2012;342(3):696–708.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Van der voort EA, Wakkee M, Veldt-kok P, Darwish murad S, Nijsten T. Enhanced liver fibrosis test (ELF) in psoriasis, psoriatic arthritis and rheumatoid arthritis patients: a cross-sectional comparison with procollagen-3 N-terminal peptide (P3NP). Br J Dermatol. 2017;176(6):1599–606. https://doi.org/10.1111/bjd.15220. Epub 2017 Apr 24

    Article  PubMed  CAS  Google Scholar 

  108. Atwan A, Ingram JR, Abbott R, et al. Oral fumaric acid esters for psoriasis: abridged Cochrane systematic review including GRADE assessments. Br J Dermatol. 2016;175(5):873–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Mueller W, Herrmann B. Cyclosporin A for psoriasis. N Engl J Med. 1979;301(10):555.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Baylor University Medical Center, Dallas, TX, USA

    Gregory Peterson MD & Alan Menter MD

  2. Texas A&M Health Science Center College of Medicine, Temple, TX, USA

    Annika Silfast-Kaiser BS

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  2. Annika Silfast-Kaiser BS
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  3. Alan Menter MD
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Correspondence to Alan Menter MD .

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  1. Division of Dermatology, David Geffen School of Medicine a UCLA, Los Angeles, California, USA

    Paul S. Yamauchi

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Peterson, G., Silfast-Kaiser, A., Menter, A. (2018). Systemic Therapies in Psoriasis. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_16

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  • DOI: https://doi.org/10.1007/978-3-319-66884-0_16

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