Psoriasis: conceptos actuales en el tratamiento sistémico.
Parte 2. Medicamentos biológicos y no tradicionales
Palabras clave:
psoriasis, tratamiento, tratamientos biológicos biomoduladores, medicamentosResumen
La psoriasis es una dermatosis en la que intervienen múltiples factores patogé- nicos que interactúan de forma compleja. En la segunda parte de este artículo, se revisan los conceptos actuales sobre los medicamentos biológicos y los considerados no tradicionales, para el tratamiento de esta entidad.
Biografía del autor/a
Francisco Alejandro Arango
Médico residente de dermatología, segundo año. Universidad de Caldas.
Mario Fernando Franco
Médico residente de dermatología, segundo año. Universidad de Caldas.
Ana María Hoyos
Médica dermatóloga. Profesora catedrática del postgrado en dermatología, Universidad de Caldas
Referencias bibliográficas
1. Lebwohl M, Bagel J, Gelfand JM, Gladman D, Gordon KB, Hsu S, et al. From the medical board of the National Psoriasis Foundation: Monitoring and vaccinations in patients treated with biologics for psoriasis. J Am Acad Dermatol. 2008;58:94-105.
2. Griffiths C, Jackson K, McHugh N, McKenna K, Reynolds N, Ormerod A. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J of Dermatol. 2009;161:987-1019.
3. Jensen P, Skov L, Zachariae C. Systemic combination treatment for psoriasis: A review. Acta Derm Venereol. 2010;90:341-9.
4. Centers for Disease control and Prevention. TB elimination, tuberculine testing. [Facts sheets]. April 2010 [last revision, June 1 2010]. Fecha de consulta: ; 20 de agoto de 2010. Disponible en: http://www.cdc.gov/tb/publications/factsheets/ testing/skintesting.htm.
5. Gordon KB, Vaishnaw AK, O’Gorman J, Haney J, Menter A. Treatment of psoriasis with alefacept: Correlation of clinical improvement with reductions of memory T-cell counts. Arch Dermatol. 2003;139:1563-70.
6. Krueger GG, Ellis CN. Alefacept therapy produces remission for patients with chronic plaque psoriasis. Br J Dermatol. 2003;148:784-8.
7. Ellis CN, Krueger GG. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med. 2001;345:248-55.
8. Chamian F, Lin SL, Lee E, Kikuchi T, Gilleaudeau P, SullivanWhalen M, et al. Alefacept (anti-CD2) causes a selective reduction in circulating effector memory T cell (Tem) ad relative preservation of central memory T cells (Tcm) in psoriasis. J Transl Med. 2007;5:27.
9. Scheinfeld N. Alefacept: A safety profile. Expert Opin Drug Saf. 2005;4:975-85.
10. Menter A, Gottlieb A, Feldman SR, 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.
11. Krueger GG. Clinical response to alefacept: results of a phase 3 study of intravenous administration of alefacept in patients with chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2003;17:17-24.
12. Ferrándiz C, Carrascosa JM, Boada A. A new era in the management of psoriasis? The biologics: Facts and controversies. Clin Dermatol. 2010;28:81-7.
13. Langley RG, Gordon KB. Duration of remission of biologic agents for chronic plaque psoriasis. J Drugs Dermatol. 2007;6:1205-12.
14. Food and Drug Administration (FDA). FDA Safety Information and Adverse Event Reporting Program. Raptiva (efalizumab), Feb. 2009. Fecha de consulta: 19 de agosto 19 de 2010. Disponible en: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm149675.htm.
15. Mazurek GH, Jereb J, Lobue P, Iademarco MF, Metchock B, Vernon A; Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC). Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep. 2005;54(RR-15):49-55. Erratum in: MMWR Morb Mortal Wkly Rep. 2005;54:1288.
16. Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA, et al. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J Dermatol. 2009;161:987-1019.
17. Gordon KB, Langley RG, Leonardi C, Toth D, Menter MA, Kang S, et al. Clinical response to adalimumab treatment in patients with moderate to severe psoriasis: Double-blind, randomized controlled trial and open-label extension study. J Am Acad Dermatol. 2006;55:598-606.
18. 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.
19. Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG. Adalimumab therapy for moderate to severe psoriasis: A randomized, controlled phase III trial. J Am Acad Dermatol. 2008;58:106-15.
20. Ellis CN, Krueger GG. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med. 2001;345:248-55.
21. Scheinfeld N. A comprehensive review and evaluation of the side effects of the tumor necrosis factor alpha blockers etanercept, infliximab and adalimumab. J Dermatolog Treat. 2004;15:280-94.
22. Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA, et al. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J Dermatol. 2009;161:987-1019.
23. O’Neill JL, Kalb RE. Ustekinumab in the therapy of chronic plaque psoriasis. Biologics. 2009;3:159-68.
24. Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y, et al. Efficacy and safety of ustekinumab, a human interleukin-12 - 23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomized, double-blind, placebocontrolled trial (PHOENIX 1). Lancet. 2008;371:1665-74.
25. Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P, Yeilding N, et al. Efficacy and safety of ustekinumab, a human interleukin-12 - 23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomized, doubleblind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371:1675-84.
26. Anstey AV, Wakelin S, Reynolds NJ. Guidelines for prescribing azathioprine in dermatology. Br J Dermatol. 2004;151:1123-32.
27. Wisehart JM. Wegener’s granulomatosis –controlled by azathioprine and corticosteroids. Br J Dermatol. 1975;92:461-7.
28. Chow RK, Ho VC. Treatment of pyoderma gangrenosum. J Am Acad Dermatol. 1996;34:1047-60.
29. Hunter GA, Forbes IJ. Treatment of pityriasis rubra pilaris with azathioprine. Br J Dermatol. 1972;87:42-5.
30. Lear JT, English JSC. Erosive and generalized lichen planus responsive to azathioprine. Clin Exp Dermatol. 1996;21:56-7.
31. Du Vivier A, Munro DD, Verbov J. Treatment of psoriasis with azathioprine. Br Med J. 1974;1:49-51.
32. Greaves MW, Dawber R. Azathioprine in psoriasis. Br Med J. 1970;2:237-8.
33. Schweckendiek W. Heilung von psoriasis vulgaris. Med Monatsschr. 1959;13:103-4.
34. Altmeyer PJ, Matthes U, Pawlak F, Hoffmann K, Frosch PJ, Ruppert P, et al. Antipsoriatic effect of fumaric acid derivatives: Results of a multicenter double-blind study in 100 patients. J Am Acad Dermatol. 1994;30:S977-81.
35. Peeters AJ, Dijkmans BA, van der Schroeff JG. Fumaric acid therapy for psoriatic arthritis: A randomized, double-blind, placebo-controlled study. Br J Rheumatol. 1992;31:502-4.
36. Mrowietz U, Asadullah K. Dimethyl fumarate for psoriasis: More than a dietary curiosity. Trends Mol Med. 2005;11:43-8.7c
37. 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.
38. Sharma VK, Dutta B, Ramam M. Hydroxyurea as an alternative therapy for psoriasis. Indian J Dermatol Venereol Leprol. 2004;70:13-7. 3
9. Layton AM, Sheehan- Dare RA, Goodfield MJD, Cotterill JA. Hydroxyurea in the management of therapy resistant psoriasis. Br J Dermatol. 1989;121:647-53.
40. McDonald CJ. Uses of systemic chemotherapeutic agents in psoriasis. Pharmacol Ther. 1981;14:1-24.
41. Marinari R, Fleischmajer R, Schragger AH, Rosenthal AL. Mycophenolic acid in the treatment of psoriasis: Long-term administration. Arch Dermatol. 1977;113:930-2.
42. Orvis AK, Wesson ST, Breza TS, Church AA, Mitchell CL, Watkins SW. Mycophenolate mofetil in dermatology. J Am Acad Dermatol. 2009;60:183-99.
43. Zhou Y, Rosenthal D, Dutz J, Ho V. Mycophenolate mofetil (CellCept) for psoriasis: A two-center, prospective, open-label clinical trial. J Cutan Med Surg. 2003;7:193-7.
44. Geilen CC, Arnold M, Orfanos CE. Mycophenolate mofetil as a systemic antipsoriatic agent: Positive experience in 11 patients. Br J Dermatol. 2001;144:583-6.
45. Bressan AL, Silva RS, Fontenelle E, Gripp AC. Immunosuppressive agents in dermatology. An Bras Dermatol. 2010;85:9-22.
46. Genovese MC, Davis JS 4th. Current management of rheumatoid arthritis. Hosp Pract. 2001;36:21-6, 29-30, 35.
47. Monteagudo I, López FJ, González CM, Carreño L. Leflunomide: A new treatment for an old disease. Rev Clin Esp. 2000;200:114-8.
48. 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, doubleblind, randomized, placebo-controlled clinical trial. Arthritis Rheum. 2004;50:1939-50.
49. Prakash A, Jarvis B. Leflunomide: A review of its use in active rheumatoid arthritis. Drugs. 1999;58:1137-64, 1190-9.
50. Gupta AK, Ellis CN, Siegel MT, Duell EA, Griffiths CE, Hamilton TA, et al. Sulfasalazine improves psoriasis: A doubleblind analysis. Arch Dermatol. 1990;126:487-93.
51. Watkinson G. Sulphasalazine: A review of 40 years’ experience. Drugs. 1986;32(Suppl.):1-11.
52. Staatz CE, Tett SE. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation. Clin Pharmacokin. 2004;10:623-54.
53. Lebwohl M, Freeman AK, Chapman MS, Feldman SR, Hartle JE, Henning A. Tacrolimus ointment is effective for facial and intertriginous psoriasis. J Am Acad Dermatol. 2004;51:723-30.
54. Yan J, Chen SL, Wang XL, Zhou W, Wang FS. Meta-analysis of tacrolimus ointment for atopic dermatitis in pediatric patients. Pediatr Dermatol. 2008;25:117-20.
55. 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.
56. Qasim A, McDonald S, Sebastian S, McLoughlin R, Buckley M, O’Connor H, et al. Efficacy and safety of 6-thioguanine in the management of inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2007;42:194-9.
57. Molin L, Thomsen K. Thioguanine treatment in psoriasis. Acta Derm Venereol (Stockh). 1987;67:85-8.
58. Zackheim HS, Maibach HI. Treatment of psoriasis with 6-thioguanine. Australas J Dermatol. 1988;29:163-7.
59. 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.
60. Silvis NG, Levine N. Pulse dosing of thioguanine in recalcitrant psoriasis. Arch Dermatol. 1999;135:433-7.
2. Griffiths C, Jackson K, McHugh N, McKenna K, Reynolds N, Ormerod A. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J of Dermatol. 2009;161:987-1019.
3. Jensen P, Skov L, Zachariae C. Systemic combination treatment for psoriasis: A review. Acta Derm Venereol. 2010;90:341-9.
4. Centers for Disease control and Prevention. TB elimination, tuberculine testing. [Facts sheets]. April 2010 [last revision, June 1 2010]. Fecha de consulta: ; 20 de agoto de 2010. Disponible en: http://www.cdc.gov/tb/publications/factsheets/ testing/skintesting.htm.
5. Gordon KB, Vaishnaw AK, O’Gorman J, Haney J, Menter A. Treatment of psoriasis with alefacept: Correlation of clinical improvement with reductions of memory T-cell counts. Arch Dermatol. 2003;139:1563-70.
6. Krueger GG, Ellis CN. Alefacept therapy produces remission for patients with chronic plaque psoriasis. Br J Dermatol. 2003;148:784-8.
7. Ellis CN, Krueger GG. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med. 2001;345:248-55.
8. Chamian F, Lin SL, Lee E, Kikuchi T, Gilleaudeau P, SullivanWhalen M, et al. Alefacept (anti-CD2) causes a selective reduction in circulating effector memory T cell (Tem) ad relative preservation of central memory T cells (Tcm) in psoriasis. J Transl Med. 2007;5:27.
9. Scheinfeld N. Alefacept: A safety profile. Expert Opin Drug Saf. 2005;4:975-85.
10. Menter A, Gottlieb A, Feldman SR, 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.
11. Krueger GG. Clinical response to alefacept: results of a phase 3 study of intravenous administration of alefacept in patients with chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2003;17:17-24.
12. Ferrándiz C, Carrascosa JM, Boada A. A new era in the management of psoriasis? The biologics: Facts and controversies. Clin Dermatol. 2010;28:81-7.
13. Langley RG, Gordon KB. Duration of remission of biologic agents for chronic plaque psoriasis. J Drugs Dermatol. 2007;6:1205-12.
14. Food and Drug Administration (FDA). FDA Safety Information and Adverse Event Reporting Program. Raptiva (efalizumab), Feb. 2009. Fecha de consulta: 19 de agosto 19 de 2010. Disponible en: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm149675.htm.
15. Mazurek GH, Jereb J, Lobue P, Iademarco MF, Metchock B, Vernon A; Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC). Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep. 2005;54(RR-15):49-55. Erratum in: MMWR Morb Mortal Wkly Rep. 2005;54:1288.
16. Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA, et al. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J Dermatol. 2009;161:987-1019.
17. Gordon KB, Langley RG, Leonardi C, Toth D, Menter MA, Kang S, et al. Clinical response to adalimumab treatment in patients with moderate to severe psoriasis: Double-blind, randomized controlled trial and open-label extension study. J Am Acad Dermatol. 2006;55:598-606.
18. 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.
19. Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG. Adalimumab therapy for moderate to severe psoriasis: A randomized, controlled phase III trial. J Am Acad Dermatol. 2008;58:106-15.
20. Ellis CN, Krueger GG. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med. 2001;345:248-55.
21. Scheinfeld N. A comprehensive review and evaluation of the side effects of the tumor necrosis factor alpha blockers etanercept, infliximab and adalimumab. J Dermatolog Treat. 2004;15:280-94.
22. Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA, et al. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J Dermatol. 2009;161:987-1019.
23. O’Neill JL, Kalb RE. Ustekinumab in the therapy of chronic plaque psoriasis. Biologics. 2009;3:159-68.
24. Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y, et al. Efficacy and safety of ustekinumab, a human interleukin-12 - 23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomized, double-blind, placebocontrolled trial (PHOENIX 1). Lancet. 2008;371:1665-74.
25. Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P, Yeilding N, et al. Efficacy and safety of ustekinumab, a human interleukin-12 - 23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomized, doubleblind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371:1675-84.
26. Anstey AV, Wakelin S, Reynolds NJ. Guidelines for prescribing azathioprine in dermatology. Br J Dermatol. 2004;151:1123-32.
27. Wisehart JM. Wegener’s granulomatosis –controlled by azathioprine and corticosteroids. Br J Dermatol. 1975;92:461-7.
28. Chow RK, Ho VC. Treatment of pyoderma gangrenosum. J Am Acad Dermatol. 1996;34:1047-60.
29. Hunter GA, Forbes IJ. Treatment of pityriasis rubra pilaris with azathioprine. Br J Dermatol. 1972;87:42-5.
30. Lear JT, English JSC. Erosive and generalized lichen planus responsive to azathioprine. Clin Exp Dermatol. 1996;21:56-7.
31. Du Vivier A, Munro DD, Verbov J. Treatment of psoriasis with azathioprine. Br Med J. 1974;1:49-51.
32. Greaves MW, Dawber R. Azathioprine in psoriasis. Br Med J. 1970;2:237-8.
33. Schweckendiek W. Heilung von psoriasis vulgaris. Med Monatsschr. 1959;13:103-4.
34. Altmeyer PJ, Matthes U, Pawlak F, Hoffmann K, Frosch PJ, Ruppert P, et al. Antipsoriatic effect of fumaric acid derivatives: Results of a multicenter double-blind study in 100 patients. J Am Acad Dermatol. 1994;30:S977-81.
35. Peeters AJ, Dijkmans BA, van der Schroeff JG. Fumaric acid therapy for psoriatic arthritis: A randomized, double-blind, placebo-controlled study. Br J Rheumatol. 1992;31:502-4.
36. Mrowietz U, Asadullah K. Dimethyl fumarate for psoriasis: More than a dietary curiosity. Trends Mol Med. 2005;11:43-8.7c
37. 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.
38. Sharma VK, Dutta B, Ramam M. Hydroxyurea as an alternative therapy for psoriasis. Indian J Dermatol Venereol Leprol. 2004;70:13-7. 3
9. Layton AM, Sheehan- Dare RA, Goodfield MJD, Cotterill JA. Hydroxyurea in the management of therapy resistant psoriasis. Br J Dermatol. 1989;121:647-53.
40. McDonald CJ. Uses of systemic chemotherapeutic agents in psoriasis. Pharmacol Ther. 1981;14:1-24.
41. Marinari R, Fleischmajer R, Schragger AH, Rosenthal AL. Mycophenolic acid in the treatment of psoriasis: Long-term administration. Arch Dermatol. 1977;113:930-2.
42. Orvis AK, Wesson ST, Breza TS, Church AA, Mitchell CL, Watkins SW. Mycophenolate mofetil in dermatology. J Am Acad Dermatol. 2009;60:183-99.
43. Zhou Y, Rosenthal D, Dutz J, Ho V. Mycophenolate mofetil (CellCept) for psoriasis: A two-center, prospective, open-label clinical trial. J Cutan Med Surg. 2003;7:193-7.
44. Geilen CC, Arnold M, Orfanos CE. Mycophenolate mofetil as a systemic antipsoriatic agent: Positive experience in 11 patients. Br J Dermatol. 2001;144:583-6.
45. Bressan AL, Silva RS, Fontenelle E, Gripp AC. Immunosuppressive agents in dermatology. An Bras Dermatol. 2010;85:9-22.
46. Genovese MC, Davis JS 4th. Current management of rheumatoid arthritis. Hosp Pract. 2001;36:21-6, 29-30, 35.
47. Monteagudo I, López FJ, González CM, Carreño L. Leflunomide: A new treatment for an old disease. Rev Clin Esp. 2000;200:114-8.
48. 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, doubleblind, randomized, placebo-controlled clinical trial. Arthritis Rheum. 2004;50:1939-50.
49. Prakash A, Jarvis B. Leflunomide: A review of its use in active rheumatoid arthritis. Drugs. 1999;58:1137-64, 1190-9.
50. Gupta AK, Ellis CN, Siegel MT, Duell EA, Griffiths CE, Hamilton TA, et al. Sulfasalazine improves psoriasis: A doubleblind analysis. Arch Dermatol. 1990;126:487-93.
51. Watkinson G. Sulphasalazine: A review of 40 years’ experience. Drugs. 1986;32(Suppl.):1-11.
52. Staatz CE, Tett SE. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation. Clin Pharmacokin. 2004;10:623-54.
53. Lebwohl M, Freeman AK, Chapman MS, Feldman SR, Hartle JE, Henning A. Tacrolimus ointment is effective for facial and intertriginous psoriasis. J Am Acad Dermatol. 2004;51:723-30.
54. Yan J, Chen SL, Wang XL, Zhou W, Wang FS. Meta-analysis of tacrolimus ointment for atopic dermatitis in pediatric patients. Pediatr Dermatol. 2008;25:117-20.
55. 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.
56. Qasim A, McDonald S, Sebastian S, McLoughlin R, Buckley M, O’Connor H, et al. Efficacy and safety of 6-thioguanine in the management of inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2007;42:194-9.
57. Molin L, Thomsen K. Thioguanine treatment in psoriasis. Acta Derm Venereol (Stockh). 1987;67:85-8.
58. Zackheim HS, Maibach HI. Treatment of psoriasis with 6-thioguanine. Australas J Dermatol. 1988;29:163-7.
59. 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.
60. Silvis NG, Levine N. Pulse dosing of thioguanine in recalcitrant psoriasis. Arch Dermatol. 1999;135:433-7.
Cómo citar
1.
Arango FA, Franco MF, Hoyos AM. Psoriasis: conceptos actuales en el tratamiento sistémico.: Parte 2. Medicamentos biológicos y no tradicionales. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 7 de marzo de 2019 [citado 18 de abril de 2024];19(1):45-54. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/387
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Arango FA, Franco MF, Hoyos AM. Psoriasis: conceptos actuales en el tratamiento sistémico.: Parte 2. Medicamentos biológicos y no tradicionales. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 7 de marzo de 2019 [citado 18 de abril de 2024];19(1):45-54. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/387
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