环孢素A在银屑病治疗中的应用
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摘要
银屑病是一种免疫介导的慢性炎症性皮肤病,环孢素A作为一种高选择性免疫抑制剂,以抑制白介素-2为主的促炎症细胞因子生成为机理,从而发挥对银屑病的治疗作用。目前无论是环孢素A单一药物的短程、长程和间断维持疗法,还是与其他治疗银屑病的系统性药物、生物制剂及紫外线光疗联合应用,均在银屑病皮损控制及疗效维持等方面有较为明确的治疗作用。本文将现阶段临床上环孢素A在银屑病治疗中的应用及相关药物特性等问题作一总结,为环孢素A临床用于银屑病治疗提供参考。
Psoriasis is a chronic inflammatory immuno-mediated disease,while cyclosporine A acts as a high selective immuno-suppressor,which aims at reducing the expression of pro-inflammatory cytokines like IL-2 to complete the task of treating the psoriasis. Nowadays,not only the short-term,long-term or intermittment monotherapy of cyclosporine A,but also the combination therapy of cyclosporine A with other systemic drugs,biological agents or ultraviolet phototherapy have therapeutic effect on the skin lesion control and curative effect maintaining. The purpose of this article is to summarize the therapeutic use of cyclosporine A in psoriasis treatment and the pharmacological characters of cyclosporine A,and so as to provide a reference for psoriasis treatment.
Psoriasis is a chronic inflammatory immuno-mediated disease,while cyclosporine A acts as a high selective immuno-suppressor,which aims at reducing the expression of pro-inflammatory cytokines like IL-2 to complete the task of treating the psoriasis. Nowadays,not only the short-term,long-term or intermittment monotherapy of cyclosporine A,but also the combination therapy of cyclosporine A with other systemic drugs,biological agents or ultraviolet phototherapy have therapeutic effect on the skin lesion control and curative effect maintaining. The purpose of this article is to summarize the therapeutic use of cyclosporine A in psoriasis treatment and the pharmacological characters of cyclosporine A,and so as to provide a reference for psoriasis treatment.
引文
[1]Goldenberg G,Lanoue J,Dong J.New oral therapies for psoriasis:A comprehensive review[J].J Clin Aesthet Dermatol,2016,9(8):25-28.
[2]Mueller W,Herrmann B.Cyclosporin a for psoriasis[J].N Engl J Med,1979,301(10):555.
[3]Amor KT,Ryan C,Menter A.The use of cyclosporine in dermatology:part I[J].J Am Acad Dermatol,2010,63(12):925-946.
[4]Madan V,Griffiths CE.Systemic ciclosporin and tacrolimus in dermatology[J].Dermatol Ther,2007,20(4):239-250.
[5]Nast A,Boehncke WH,Mrowietz U,et al.S3-Guidelines on the treatment of psoriasis vulgaris(English version).Update[J].J Dtsch Dermatol Ges,2012,10(2 suppl.):S1-95.
[6]Dawar FU,Xiong Y,Khattak MNK,et al.Potential role of cyclophilin A in regulating cytokine secretion[J].J Leukoc Biol,2017,102(4):989-992.
[7]Prens EP,van Joost T,Hegmans JP,et al.Effects of cyclosporine on cytokines and cytokine receptors in psoriasis[J].J Am Acad Dermatol,1995,33(6):947-953.
[8]Soleymani T,Vassantachart JM,Wu JJ.Comparison of guidelines for the use of cyclosporine for psoriasis:A critical appraisal and comprehensive review[J].J Drugs Dermatol,2016,15(3):293-301.
[9]徐亚飞,董瑞华,曲恒燕,等.CYP3A和MDR1基因多态性对环孢素A药代动力学的影响[J].国际药学研究杂志,2015,42(2):148-151.
[10]Griffiths CEM,Clark CM,Chalmers RJG,et al.A systematic review of treatments for severe psoriasis[J].Health Technol Assess,2000,4(40):1-125.
[11]Griffiths CE,Dubertret L,Ellis CN,et al.Ciclosporin in psoriasis clinical practice:an international consensus statement[J].Br J Dermatol,2004,150(67 suppl.):11-23.
[12]Okubo Y,Natsume S,Usui K,et al.Low-dose,short-term ciclosporin(Neoral)therapy is effective in improving patients'quality of life as assessed by Skindex-16 and GHQ-28 in mild to severe psoriasis patients[J].J Dermatol,2011,38(5):465-472.
[13]Zachariae R,Zachariae H,Blomqvist K,et al.Quality of life in 6497 Nordic patients with psoriasis[J].Br J Dermatol,2002,146(6):1006-1016.
[14]Sticherling M,Augustin M,Boehncke WH,et al.Therapy of psoriasis in childhood and adolescence-a German expert consensus[J].J Dtsch Dermatol Ges,2011,9(10):815-823.
[15]Dogra S,Mahajan R,Narang T,et al.Systemic cyclosporine treatment in severe childhood psoriasis:A retrospective chart review[J].J Dermatolog Treat,2017,28(1):18-20.
[16]Strober BE.Methotrexate and cyclosporine in psoriasis revisited[J].Semin Cutan Med Surg,2014,33(2):S27-30.
[17]Bangsgaard N,Rrbye C,Skov L.Treating psoriasis during pregnancy:safety and efficacy of treatments[J].Am J Clin Dermatol,2015,16(5):389-398.
[18]Pathirana D,Ormerod AD,Saiag P,et al.European S3-guidelines on the systemic treatment of psoriasis vulgaris[J].J Eur Acad Dermatol Venereol,2009,23(2 Suppl.):1-70.
[19]Nast A,Gisondi P,Ormerod AD,et al.European S3-guidelines on the systemic treatment of psoriasis vulgaris-Update2015-Shortversion-EDF in cooperation with EADV and IPC[J].J Eur Acad Dermatol Venereol,2015,29(12):2277-2294.
[20]Koo J.A randomized,double-blind study comparing the efficacy,safety and optimal dose of two formulations of cyclosporin,Neoral and Sandimmun,in patients with severe psoriasis.OLP302 study group[J].Br J Dermatol,1998,139(1):88-95.
[21]Ellis CN,Fradin MS,Messana JM,et al.Cyclosporine for plaque-type psoriasis.Results of a multidose,double-blind trial[J].N Engl J Med,1991,324(5):277-284.
[22]Heydendael VM,Spuls PI,Opmeer BC,et al.Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis[J].N Engl J Med,2003,349(7):658-665.
[23]Thaci D,Brautigam M,Kaufmann R,et al.Body-weight-independent dosing of cyclosporine micro-emulsion and three times weekly maintenance regimen in severe psoriasis.A randomised study[J].Dermatology,2002,205(4):383-388.
[24]Mahrle G,Schulze HJ,Farber L,et al.Low-dose short-term cyclosporine versus etretinate in psoriasis:improvement of skin,nail,and joint involvement[J].J Am Acad Dermatol,1995,32(1):78-88.
[25]Elder CA,Moore M,Chang CT,et al.Efficacy and pharmacokinetics of two formulations of cyclosporine A in patients with psoriasis[J].J Clin Pharmacol,1995,35(9):865-875.
[26]Engst R,Huber J.Results of cyclosporin treatment of severe,chronic psoriasis vulgaris[J].Hautarzt,1989,40(8):486-489.
[27]Finzi AF,Mozzanica N,Pigatto PD,et al.Cyclosporin versus etretinate:Italian multicenter comparative trial in severe plaque-form psoriasis.Italian Multicenter Study Group on Cyclosporin in Psoriasis[J].Dermatology,1993,187(1Suppl.):8-18.
[28]Laburte C,Grossman R,Abi-Rached J,et al.Efficacy and safety of oral cyclosporin A(Cy A;Sandimmun)for longterm treatment of chronic severe plaque psoriasis[J].Br J Dermatol,1994,130(3):366-375.
[29]Levell NJ,Shuster S,Munro CS,et al.Remission of ordinary psoriasis following a short clearance course of cyclosporin[J].Acta Derm Venereol,1995,75(1):65-69.
[30]Meffert H,Brautigam M,Farber L,et al.Low-dose(1.25mg/kg)cyclosporin A:treatment of psoriasis and investigation of the influence on lipid profile[J].Acta Derm Venereol,1997,77(2):137-141.
[31]Reitamo S,Spuls P,Sassolas B,et al.Efficacy of sirolimus(rapamycin)administered concomitantly with a subtherapeutic dose of cyclosporin in the treatment of severe psoriasis:a randomized controlled trial[J].Br J Dermatol,2001,145(3):438-445.
[32]Finzi AF,Mozzanica N,Cattaneo A,et al.Effectiveness of cyclosporine treatment in severe psoriasis:a clinical and immunologic study[J].J Am Acad Dermatol,1989,21(1):91-97.
[33]Grossman RM,Thivolet J,Claudy A,et al.A novel therapeutic approach to psoriasis with combination calcipotriol ointment and very low-dose cyclosporine:results of a multicenter placebo-controlled study[J].J Am Acad Dermatol,1994,31(1):68-74.
[34]Higgins E,Munro C,Marks J,et al.Relapse rates in moderately severe chronic psoriasis treated with cyclosporin A[J].Br J Dermatol,1989,121(1):71-74.
[35]Colombo MD,Cassano N,Bellia G,et al.Cyclosporine regimens in plaque psoriasis:An overview with special emphasis on dose,duration,and old and new treatment approaches[J].Scientific World Journal,2013,25:805705.
[36]Zachariae H,Steen Olsen T.Efficacy of cyclosporin A(Cy A)in psoriasis:an overview of dose/response,indications,contraindications and side-effects[J].Clin Nephrol,1995,43(3):154-158.
[37]Ho VC,Griffiths CE,Albrecht G,et al.Intermittent short courses of cyclosporin(Neoral)for psoriasis unresponsive to topical therapy:a 1-year multicentre,randomized study[J].Br J Dermatol,1999,141(2):283-291.
[38]Borghi A,Corazza M,Mantovani L,et al.Prolonged cyclosporine treatment of severe or recalcitrant psoriasis:descriptive study in a series of 20 patients[J].Int J Dermatol,2012,51(12):1512-1516.
[39]Colombo D,Cassano N,Altomare G,et al.Psoriasis relapse evaluation with Week-End cyclosporine a treatment:Results of a randomized,Double-Blind,multicenter study[J].Int J Immunopathol Pharmacol,2010,23(4):1143-1152.
[40]Feltes F,Macías del Toro E,Ramírez Bellver JL,et al.Weekend ciclosporin maintenance therapy for moderate psoriasis[J].Actas Dermosifiliogr,2015,106(7):583-584.
[41]Babino G,Giunta A,Ruzzetti M,et al.Combination therapy with etanercept in psoriasis:Retrospective analysis of efficacy and safety outcomes from real-life practice[J].J Int Med Res,2016,44(1 suppl.):100-105.
[42]Esposito M,Gisondi P,Cassano N,et al.Survival rate of antitumour necrosis factor-αtreatments for psoriasis in routine dermatological practice:a multicentre observational study[J].Br J Dermatol,2013,169(3):666-672.
[43]Balighi K,Zahra GS,Azadeh G,et al.Assessment of the therapeutic aspect of systemic Non-Biologic Anti-Psoriatic treatment modalities used in combination with methotrexate[J].Indian J Dermatol,2016,61(1):118.
[44]Prajs K,Fliciski J,Przepiera-Bedzak H,et al.Adverse effects of cyclosporine A observed in rheumatoid arthritis and psoriatic arthritis[J].Ann Acad Med Stetin,2010,56(1 suppl.):48-51.
[45]Mehta D,Lim HW.Ultraviolet B phototherapy for psoriasis:Review of practical guidelines[J].Am J Clin Dermatol,2016,17(2):125-133.
[46]Hashizume H,Ito T,Yagi H,et al.Efficay and safety of preprandial versus postprandial administration of low-dose cyclosporine microemulsion(Neoral)in patients with psoriasis vulgaris[J].J Dermatol,2007,34(7):430-434.
[47]Kusaba T,Konno Y,Hatta S,et al.More stable and reliable pharmacokinetics with preprandial administration of cyclosporine compared with postprandial administration in patients with refractory nephrotic syndrome[J].Pharmacotherapy,2005,25(1):52-58.
[48]Smith KC.Systemic therapy of psoriasis using methotrexate[J].Skin Therapy Lett,2000,6(3):1-2.
[49]Saurat JH,Langley RG,Reich K,et al.Relationship between methotrexate dosing and clinical response in patients with moderate to severe psoriasis:Subanalysis of the CHAMPION study[J].Br J Dermatol,2011,165(2):399-406.
[50]van Ede AE,Laan RF,Rood MJ,et al.Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis:a forty-eight week,multicenter,randomized,double-blind,placebo-controlled study[J].Arthritis Rheum,2001,44(7):1515-1524.
[51]Sbidian E,Maza A,Montaudie H,et al.Efficacy and safety of oral retinoids in different psoriasis subtypes:a systematic literature review[J].J Eur Acad Dermatol Venereol,2011,25(2 Suppl.):28-33.
[52]Ak9ali C,Guven EH,Kirtak N,et al.Serum concentrations of interleukin-2 and tumour necrosis factor-αunder cyclosporine versus acitretin treatment in plaque-type psoriasis[J].J Int Med Res,2014,42(5):1118-1122.
[53]Mahrle G,Schulze HJ,Frber L,et al.Low-dose short-term cyclosporine versus etretinate in psoriasis:improvement of skin,nail,and joint involvement[J].J Am Acad Dermatol,1995,32(1):78-88.
[54]Borghi A,Corazza M,Bertoldi AM,et al.Low-dose acitretin in treatment of plaque-type psoriasis:descriptive study of efficacy and safety[J].Acta Derm Venereol,2015,95(3):332-336.
[55]Orvis AK,Wesson SK,Breza TS Jr,et al.Mycophenolate mofetil in dermatology[J].J Am Acad Dermatol,2009,60(2):183-199.
[56]Ji YZ,Geng L,Ma XH,et al.Severe generalized pustular psoriasis treated with mycophenolate mofetil[J].J Dermatol,2011,38(6):603-605.
[57]Beissert S,Pauser S,Sticherling M,et al.A comparison of mycophenolate mofetil with ciclosporine for the treatment of chronic plaque-type psoriasis[J].Dermatology,2009,219(2):126-132.
[58]Zwerner J,Fiorentino D.Mycophenolate mofetil[J].Dermatol Ther,2007,20(4):229-238.
[59]Buell C,Koo J.Long-term safety of mycophenolate mofetil and cyclosporine:a review[J].J Drugs Dermatol,2008,7(8):741-748.
[60]Chander V,Singh D,Tirkey N,et al.Amelioration of cyclosporine nephrotoxicity by irbesartan,a selective AT1 receptor antagonist[J].Ren Fail,2004,26(5):467-477.
[61]Rosmarin DM,Lebwohl M,Elewski BE,et al.Cyclosporine and psoriasis:2008 National Psoriasis Foundation Consensus Conference[J].J Am Acad Dermatol,2010,62(5):838-853.
[62]Ryan C,Amor KT,Menter A.The use of cyclosporine in dermatology:partⅡ[J].J Am Acad Dermatol,2010,63(6):949-972.
[63]Kolios AG,Yawalkar N,Anliker M,et al.Swiss S1 guidelines on the systemic treatment of psoriasis vulgaris[J].Dermatology,2016,232(4):385-406.
[2]Mueller W,Herrmann B.Cyclosporin a for psoriasis[J].N Engl J Med,1979,301(10):555.
[3]Amor KT,Ryan C,Menter A.The use of cyclosporine in dermatology:part I[J].J Am Acad Dermatol,2010,63(12):925-946.
[4]Madan V,Griffiths CE.Systemic ciclosporin and tacrolimus in dermatology[J].Dermatol Ther,2007,20(4):239-250.
[5]Nast A,Boehncke WH,Mrowietz U,et al.S3-Guidelines on the treatment of psoriasis vulgaris(English version).Update[J].J Dtsch Dermatol Ges,2012,10(2 suppl.):S1-95.
[6]Dawar FU,Xiong Y,Khattak MNK,et al.Potential role of cyclophilin A in regulating cytokine secretion[J].J Leukoc Biol,2017,102(4):989-992.
[7]Prens EP,van Joost T,Hegmans JP,et al.Effects of cyclosporine on cytokines and cytokine receptors in psoriasis[J].J Am Acad Dermatol,1995,33(6):947-953.
[8]Soleymani T,Vassantachart JM,Wu JJ.Comparison of guidelines for the use of cyclosporine for psoriasis:A critical appraisal and comprehensive review[J].J Drugs Dermatol,2016,15(3):293-301.
[9]徐亚飞,董瑞华,曲恒燕,等.CYP3A和MDR1基因多态性对环孢素A药代动力学的影响[J].国际药学研究杂志,2015,42(2):148-151.
[10]Griffiths CEM,Clark CM,Chalmers RJG,et al.A systematic review of treatments for severe psoriasis[J].Health Technol Assess,2000,4(40):1-125.
[11]Griffiths CE,Dubertret L,Ellis CN,et al.Ciclosporin in psoriasis clinical practice:an international consensus statement[J].Br J Dermatol,2004,150(67 suppl.):11-23.
[12]Okubo Y,Natsume S,Usui K,et al.Low-dose,short-term ciclosporin(Neoral)therapy is effective in improving patients'quality of life as assessed by Skindex-16 and GHQ-28 in mild to severe psoriasis patients[J].J Dermatol,2011,38(5):465-472.
[13]Zachariae R,Zachariae H,Blomqvist K,et al.Quality of life in 6497 Nordic patients with psoriasis[J].Br J Dermatol,2002,146(6):1006-1016.
[14]Sticherling M,Augustin M,Boehncke WH,et al.Therapy of psoriasis in childhood and adolescence-a German expert consensus[J].J Dtsch Dermatol Ges,2011,9(10):815-823.
[15]Dogra S,Mahajan R,Narang T,et al.Systemic cyclosporine treatment in severe childhood psoriasis:A retrospective chart review[J].J Dermatolog Treat,2017,28(1):18-20.
[16]Strober BE.Methotrexate and cyclosporine in psoriasis revisited[J].Semin Cutan Med Surg,2014,33(2):S27-30.
[17]Bangsgaard N,Rrbye C,Skov L.Treating psoriasis during pregnancy:safety and efficacy of treatments[J].Am J Clin Dermatol,2015,16(5):389-398.
[18]Pathirana D,Ormerod AD,Saiag P,et al.European S3-guidelines on the systemic treatment of psoriasis vulgaris[J].J Eur Acad Dermatol Venereol,2009,23(2 Suppl.):1-70.
[19]Nast A,Gisondi P,Ormerod AD,et al.European S3-guidelines on the systemic treatment of psoriasis vulgaris-Update2015-Shortversion-EDF in cooperation with EADV and IPC[J].J Eur Acad Dermatol Venereol,2015,29(12):2277-2294.
[20]Koo J.A randomized,double-blind study comparing the efficacy,safety and optimal dose of two formulations of cyclosporin,Neoral and Sandimmun,in patients with severe psoriasis.OLP302 study group[J].Br J Dermatol,1998,139(1):88-95.
[21]Ellis CN,Fradin MS,Messana JM,et al.Cyclosporine for plaque-type psoriasis.Results of a multidose,double-blind trial[J].N Engl J Med,1991,324(5):277-284.
[22]Heydendael VM,Spuls PI,Opmeer BC,et al.Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis[J].N Engl J Med,2003,349(7):658-665.
[23]Thaci D,Brautigam M,Kaufmann R,et al.Body-weight-independent dosing of cyclosporine micro-emulsion and three times weekly maintenance regimen in severe psoriasis.A randomised study[J].Dermatology,2002,205(4):383-388.
[24]Mahrle G,Schulze HJ,Farber L,et al.Low-dose short-term cyclosporine versus etretinate in psoriasis:improvement of skin,nail,and joint involvement[J].J Am Acad Dermatol,1995,32(1):78-88.
[25]Elder CA,Moore M,Chang CT,et al.Efficacy and pharmacokinetics of two formulations of cyclosporine A in patients with psoriasis[J].J Clin Pharmacol,1995,35(9):865-875.
[26]Engst R,Huber J.Results of cyclosporin treatment of severe,chronic psoriasis vulgaris[J].Hautarzt,1989,40(8):486-489.
[27]Finzi AF,Mozzanica N,Pigatto PD,et al.Cyclosporin versus etretinate:Italian multicenter comparative trial in severe plaque-form psoriasis.Italian Multicenter Study Group on Cyclosporin in Psoriasis[J].Dermatology,1993,187(1Suppl.):8-18.
[28]Laburte C,Grossman R,Abi-Rached J,et al.Efficacy and safety of oral cyclosporin A(Cy A;Sandimmun)for longterm treatment of chronic severe plaque psoriasis[J].Br J Dermatol,1994,130(3):366-375.
[29]Levell NJ,Shuster S,Munro CS,et al.Remission of ordinary psoriasis following a short clearance course of cyclosporin[J].Acta Derm Venereol,1995,75(1):65-69.
[30]Meffert H,Brautigam M,Farber L,et al.Low-dose(1.25mg/kg)cyclosporin A:treatment of psoriasis and investigation of the influence on lipid profile[J].Acta Derm Venereol,1997,77(2):137-141.
[31]Reitamo S,Spuls P,Sassolas B,et al.Efficacy of sirolimus(rapamycin)administered concomitantly with a subtherapeutic dose of cyclosporin in the treatment of severe psoriasis:a randomized controlled trial[J].Br J Dermatol,2001,145(3):438-445.
[32]Finzi AF,Mozzanica N,Cattaneo A,et al.Effectiveness of cyclosporine treatment in severe psoriasis:a clinical and immunologic study[J].J Am Acad Dermatol,1989,21(1):91-97.
[33]Grossman RM,Thivolet J,Claudy A,et al.A novel therapeutic approach to psoriasis with combination calcipotriol ointment and very low-dose cyclosporine:results of a multicenter placebo-controlled study[J].J Am Acad Dermatol,1994,31(1):68-74.
[34]Higgins E,Munro C,Marks J,et al.Relapse rates in moderately severe chronic psoriasis treated with cyclosporin A[J].Br J Dermatol,1989,121(1):71-74.
[35]Colombo MD,Cassano N,Bellia G,et al.Cyclosporine regimens in plaque psoriasis:An overview with special emphasis on dose,duration,and old and new treatment approaches[J].Scientific World Journal,2013,25:805705.
[36]Zachariae H,Steen Olsen T.Efficacy of cyclosporin A(Cy A)in psoriasis:an overview of dose/response,indications,contraindications and side-effects[J].Clin Nephrol,1995,43(3):154-158.
[37]Ho VC,Griffiths CE,Albrecht G,et al.Intermittent short courses of cyclosporin(Neoral)for psoriasis unresponsive to topical therapy:a 1-year multicentre,randomized study[J].Br J Dermatol,1999,141(2):283-291.
[38]Borghi A,Corazza M,Mantovani L,et al.Prolonged cyclosporine treatment of severe or recalcitrant psoriasis:descriptive study in a series of 20 patients[J].Int J Dermatol,2012,51(12):1512-1516.
[39]Colombo D,Cassano N,Altomare G,et al.Psoriasis relapse evaluation with Week-End cyclosporine a treatment:Results of a randomized,Double-Blind,multicenter study[J].Int J Immunopathol Pharmacol,2010,23(4):1143-1152.
[40]Feltes F,Macías del Toro E,Ramírez Bellver JL,et al.Weekend ciclosporin maintenance therapy for moderate psoriasis[J].Actas Dermosifiliogr,2015,106(7):583-584.
[41]Babino G,Giunta A,Ruzzetti M,et al.Combination therapy with etanercept in psoriasis:Retrospective analysis of efficacy and safety outcomes from real-life practice[J].J Int Med Res,2016,44(1 suppl.):100-105.
[42]Esposito M,Gisondi P,Cassano N,et al.Survival rate of antitumour necrosis factor-αtreatments for psoriasis in routine dermatological practice:a multicentre observational study[J].Br J Dermatol,2013,169(3):666-672.
[43]Balighi K,Zahra GS,Azadeh G,et al.Assessment of the therapeutic aspect of systemic Non-Biologic Anti-Psoriatic treatment modalities used in combination with methotrexate[J].Indian J Dermatol,2016,61(1):118.
[44]Prajs K,Fliciski J,Przepiera-Bedzak H,et al.Adverse effects of cyclosporine A observed in rheumatoid arthritis and psoriatic arthritis[J].Ann Acad Med Stetin,2010,56(1 suppl.):48-51.
[45]Mehta D,Lim HW.Ultraviolet B phototherapy for psoriasis:Review of practical guidelines[J].Am J Clin Dermatol,2016,17(2):125-133.
[46]Hashizume H,Ito T,Yagi H,et al.Efficay and safety of preprandial versus postprandial administration of low-dose cyclosporine microemulsion(Neoral)in patients with psoriasis vulgaris[J].J Dermatol,2007,34(7):430-434.
[47]Kusaba T,Konno Y,Hatta S,et al.More stable and reliable pharmacokinetics with preprandial administration of cyclosporine compared with postprandial administration in patients with refractory nephrotic syndrome[J].Pharmacotherapy,2005,25(1):52-58.
[48]Smith KC.Systemic therapy of psoriasis using methotrexate[J].Skin Therapy Lett,2000,6(3):1-2.
[49]Saurat JH,Langley RG,Reich K,et al.Relationship between methotrexate dosing and clinical response in patients with moderate to severe psoriasis:Subanalysis of the CHAMPION study[J].Br J Dermatol,2011,165(2):399-406.
[50]van Ede AE,Laan RF,Rood MJ,et al.Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis:a forty-eight week,multicenter,randomized,double-blind,placebo-controlled study[J].Arthritis Rheum,2001,44(7):1515-1524.
[51]Sbidian E,Maza A,Montaudie H,et al.Efficacy and safety of oral retinoids in different psoriasis subtypes:a systematic literature review[J].J Eur Acad Dermatol Venereol,2011,25(2 Suppl.):28-33.
[52]Ak9ali C,Guven EH,Kirtak N,et al.Serum concentrations of interleukin-2 and tumour necrosis factor-αunder cyclosporine versus acitretin treatment in plaque-type psoriasis[J].J Int Med Res,2014,42(5):1118-1122.
[53]Mahrle G,Schulze HJ,Frber L,et al.Low-dose short-term cyclosporine versus etretinate in psoriasis:improvement of skin,nail,and joint involvement[J].J Am Acad Dermatol,1995,32(1):78-88.
[54]Borghi A,Corazza M,Bertoldi AM,et al.Low-dose acitretin in treatment of plaque-type psoriasis:descriptive study of efficacy and safety[J].Acta Derm Venereol,2015,95(3):332-336.
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