BACKGROUND: This retrospective observational study aimed to investigate the long-term safety, drug survival, and factors associated with the survival of acitretin in a real-world setting. METHODS: Data of adult patients with psoriasis who attended Siriraj Hospital between 2012 and 2017 and were treated with acitretin were reviewed. Demographic data and clinical courses were recorded. The Kaplan-Meier curve and Cox regression were used to calculate drug survival and the factors associated with drug survival, respectively. RESULTS: Of 104 patients, 56 and 48 were male and female, respectively, with a mean treatment duration of 3.2 years. The mean cumulative dose per patient was 19.28 ± 7.84 mg/day. Acitretin was administered to 73, 39, 24, and six patients for more than 1, 3, 5, and 10 years, respectively. Most side effects were mild and tolerable; only nine patients withdrew acitretin due to side effects. No patients developed clinical features of cirrhosis or uncontrolled hyperlipidemia. The drug survival rates were 79%, 69.5%, 61.2%, 57.6%, and 53.5% at 1, 2, 3, 4, and 5 years, respectively, higher than those of previous studies. Patients without obesity, metabolic syndrome, and dyslipidemia did not have a significantly longer acitretin survival compared to patients with these comorbidities. CONCLUSIONS: Long-term, low-dose acitretin in patients with psoriasis is unlikely to cause significant liver or lipid problems. In countries with difficulty accessing biological agents for psoriasis, acitretin may have a high drug survival rate due to its long-term safety. This study has several limitations: its retrospective nature, single-center study design, and small sample size.
BACKGROUND: This retrospective observational study aimed to investigate the long-term safety, drug survival, and factors associated with the survival of acitretin in a real-world setting. METHODS: Data of adult patients with psoriasis who attended Siriraj Hospital between 2012 and 2017 and were treated with acitretin were reviewed. Demographic data and clinical courses were recorded. The Kaplan-Meier curve and Cox regression were used to calculate drug survival and the factors associated with drug survival, respectively. RESULTS: Of 104 patients, 56 and 48 were male and female, respectively, with a mean treatment duration of 3.2 years. The mean cumulative dose per patient was 19.28 ± 7.84 mg/day. Acitretin was administered to 73, 39, 24, and six patients for more than 1, 3, 5, and 10 years, respectively. Most side effects were mild and tolerable; only nine patients withdrew acitretin due to side effects. No patients developed clinical features of cirrhosis or uncontrolled hyperlipidemia. The drug survival rates were 79%, 69.5%, 61.2%, 57.6%, and 53.5% at 1, 2, 3, 4, and 5 years, respectively, higher than those of previous studies. Patients without obesity, metabolic syndrome, and dyslipidemia did not have a significantly longer acitretin survival compared to patients with these comorbidities. CONCLUSIONS: Long-term, low-dose acitretin in patients with psoriasis is unlikely to cause significant liver or lipid problems. In countries with difficulty accessing biological agents for psoriasis, acitretin may have a high drug survival rate due to its long-term safety. This study has several limitations: its retrospective nature, single-center study design, and small sample size.
Authors: Andrea L Zaenglein; Moise L Levy; Nicole S Stefanko; Latanya T Benjamin; Anna L Bruckner; Keith Choate; Brittany G Craiglow; John J DiGiovanna; Lawrence F Eichenfield; Peter Elias; Philip Fleckman; Leslie P Lawley; Richard A Lewis; Anne W Lucky; Erin F Mathes; Leonard M Milstone; Amy S Paller; Sonali S Patel; Dawn H Siegel; Joyce Teng; Sherry A Tanumihardjo; Lauren Thaxton; Mary L Williams Journal: Pediatr Dermatol Date: 2020-11-10 Impact factor: 1.588
Authors: Chandra L Kakarala; Mohammad Hassan; Rishab Belavadi; Sri Vallabh Reddy Gudigopuram; Ciri C Raguthu; Harini Gajjela; Iljena Kela; Ibrahim Sange Journal: Cureus Date: 2021-11-17
Authors: J L W Lambert; S Segaert; P D Ghislain; T Hillary; A Nikkels; F Willaert; J Lambert; R Speeckaert Journal: J Eur Acad Dermatol Venereol Date: 2020-08 Impact factor: 6.166