tacrolimus and tazarotene

The largest proportion of psoriasis patients are candidates for topical treatment rather than treatment paradigms encompassing systemic, biologic and apremilast, and phototherapy, making skillfulness with topical therapy of paramount importance. As such, numerous studies have been conducted to demonstrate the benefits of using topical therapy in combination with other therapies. In addition, innovative uses of otherwise conventional methods, such as proactive use to minimize flare, have been developed. This article reviews five types of strategies for improved efficacy from topical agents beyond monotherapy. These strategies include proactive use, rotational therapy, sequential therapy, using topical agents to shorten the onset of therapeutic action for slower internal agents or phototherapy, and combination use for added efficacy. Each of these is reviewed in detail.

Topics: Administration, Topical; Calcitriol; Clobetasol; Databases, Factual; Dermatologic Agents; Humans; Nicotinic Acids; Phototherapy; Psoriasis; Tacrolimus

Psoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes.

Topics: Administration, Cutaneous; Anthralin; Betamethasone; Calcitriol; Dermatologic Agents; Drug Combinations; Drug Therapy, Combination; Evidence-Based Medicine; Glucocorticoids; Humans; Nicotinic Acids; Patient Compliance; Pharmaceutical Vehicles; Practice Guidelines as Topic; Psoriasis; Quality of Life; Severity of Illness Index; Tacrolimus; Treatment Outcome; Vitamin D

Psoriasis is a chronic inflammatory disease causing important physical and psychological morbidity. Topical treatments are the first choice therapeutic alternatives for mild and moderate psoriasis. We review the different topical treatment options for this common skin disease.

Topics: Administration, Cutaneous; Anthralin; Calcitriol; Dermatologic Agents; Drug Administration Schedule; Drug Therapy, Combination; Emollients; Humans; Keratolytic Agents; Nicotinic Acids; Ointments; Psoriasis; PUVA Therapy; Quality of Life; Tacrolimus; Treatment Outcome; Vitamins

Psoriasis is a chronic skin disorder that affects approximately 2% of the US and European population. Over the last several years, one of the major focuses in psoriasis research has been the development of biologic therapies for this disease. The aim of these therapies is to provide selective, immunologically directed intervention with fewer side effects than traditional therapies. The goal of this article is to review the progress of the biologic agents which are available, or under investigation for clinical use: infliximab, etanercept, efalizumab, alefacept, and adalimumab. In addition, two other investigational therapies, oral tazarotene and oral pimecrolimus will be discussed. Clinical data for these agents, including the most recent phase II and/or III study results, will be discussed, as well as the most recent safety data.

Topics: Adalimumab; Administration, Oral; Alefacept; Animals; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Etanercept; Humans; Immunoglobulin G; Infliximab; Meta-Analysis as Topic; Nicotinic Acids; Psoriasis; Receptors, Tumor Necrosis Factor; Recombinant Fusion Proteins; Tacrolimus; Treatment Outcome

Topics: Adalimumab; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Biological Products; Cyclosporine; Dermatologic Agents; Forecasting; Fumarates; Humans; Infliximab; Nicotinic Acids; Psoriasis; Receptors, Tumor Necrosis Factor; Receptors, Tumor Necrosis Factor, Type I; Tacrolimus; Tumor Necrosis Factor Decoy Receptors; Ustekinumab