Etretinate, an effective retinoid in the treatment of pustular, erythrodermic and chronic plaque type type psoriasis, has the disadvantage of a long erminal elimination half-life. On the other hand, acitretin, the active metabolite of etretinate,
has
much shorter terminal elimina tion half-life and is being reported as an agent with good antipsoriatic activity by several au thors. To evaluate the clinical efficacy of acitretin in comparison with etretinate, we treated 10 patients with
acitretin
at a
dose of 30mg per day and 11 patients with etretinate at a same dose for 12 weeks.
The PASI score at 12 week was significantly reduced in each group as compared with baseline PASI score. In the acitretin treated group the initial PASI score of 14.5 reduced to 3.9, while the etretinate group PASI score reduced from 12.0 to 3.1.
The
PASI score differences between the acitretin and etretinate groups at each time during therapy and the end of therapy were not statistically significant. The severity of adverse reactions with acitretin was similar to those with etretinate but
their
incidence was higher. The change in laboratory parameters in the acitretin group was similar to that of the etretinate group.
In view of these results and the known pharmacokinetic advantage of acitretin, that is, the short terminal elimination half-life, it is conceivable that acitretin may be a useful alternative to etreatinate in the treatment of psoriasis.
(Kor J Dermatol 1992 ; 30 (3) : 354-361)
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