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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Therapy of psoriasis The department has made a major contribution to the development of systemic treatments for psoriasis. With respect to the classical systemic treatments, long-term efficacy and safety has been studied for many years. In a multi-center study, designed by the department of dermatology, the addition of topical treatment with calcipotriol to methotrexate improved the efficacy.[1] Hepatotoxicity to methotrexate was studied in a large population of patients and proved to be relatively infrequent.[2] With the introduction of biologics, a patient registry has been established with detailed information on disease characteristics, efficacy and safety outcome measures. Important new information on long-term efficacy and safety is provided from this registry created by Elke de Jong and her colleagues. Firstly it was shown that the efficacy in real clinical practice was lower when compared to clinical trials.[3] Combination treatment of etanercept and methotrexate proved to have an increased efficacy compared to etanercept monotherapy.[4] The relevance of laboratory screening during treatment with biologics was assessed.[5] The limited information retrieved from these investigations suggest that a critical appraisal is needed on the relevance of several routine screenings in real clinical practice. Studies on real clinical practice require professional epidemiological evaluation methods as long-term efficacy figures depend to a large extent on the methods of analyses used. 110 Dermatology department staff, Nijmegen University Medical Center (1968). BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:40 Pagina 110