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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
111 Between 1990 and the year 2000 the department has investigated efficacy and safety of topical treatments in psoriasis. With respect to dithranol treatment, short contact treatment regimens were developed. At the day care unit an innovative care instruction programme was developed which helped the patient to increase adherence to his treatment.[6] Innovative principles in systemic treatment were combinations of vitamin D-based treatments and systemic treatments. The combination of vitamin D and acitretin and methotrexate proved to be both safe and highly effective.[7] The department also participated in important registration and post-registration studies on biologics.[8,9] Currently, studies on small molecules targeting the pathogenesis of psoriasis are in progress. Of particular interest is a small molecule targeted to phospodiesterase E4. Phase 3 studies reveal efficacy and safety in a large population of patients.[10] The treatment paradigm of psoriasis has changed from an empirical to a pathogenesis-based one. Important opportunities for personalized treatment with co-diagnostics are on the horizon. References 1. Jong EM de, Mørk NJ, Seijger MM, et al. The combination of calcipotriol and methotrexate compared with methotrexate and vehicle in psoriasis: results of a multicenter placebo-controlled randomized trial. Br J Dermatol 2003; 148: 318-25. 2. Berends MA, van Oijen MG, Snoek J, et al. Reliability of the Roenigk classification of liver damage after methotrexate treatment for psoriasis: a clinicopathologic study of 160 liver biopsy specimens. Arch Dermatol 2007; 143: 1515-9. 3. Lümig PP van, Driessen RJ, Boezeman JB, et al. Long-term efficacy of etanercept for psoriasis in daily practice. Br J Dermatol 2012; 166: 445-7. 4. Driessen RJ, van de Kerkhof PC, de Jong EM. Etanercept combined with methotrexate for high-need psoriasis. Br J Dermatol 2008; 159: 460-3. 5. Lümig PP van, Driessen RJ, Roelofs-Thijssen MA, et al. Relevance of laboratory investigations in monitoring patients with psoriasis on etanercept or adalimumab. Br J Dermatol 2011; 165: 375-82. 6. Swinkels OQ, Prins M, Veenhuis RT, et al. Effectiveness and side effects of UVB-phototherapy, dithranol inpatient therapy and a care instruction programme of short contact dithranol in moderate to severe psoriasis. Eur J Dermatol 2004; 14: 159-65. 7. Kerkhof PC van de, Cambazard F, Hutchinson PE, et al. The Effect of Addition of Calcipotriol Ointment (50 ug/g) to Acitretin Therapy in Psoriasis. Br J Dermatol 1998; 138: 84-9. 8. Kerkhof PCM van de, Segaert S, Lahfa M, et al. Once weekly administration of etanercept 50 mg is efficacious and will tolerated in patients with moderate to severe plaque psoriasis. Br J Dermatol 2008; 159: 1177-85. 9. Griffiths CHEM, Strober B, van de Kerkhof PCM, et al. Randomized comparison of ustekinumab with etanercept in moderate-to-severe psoriasis. New Eng J Med 2010; 362: 118-28 10. Kerkhof PC van de. Apremilast: a step forward in the treatment of psoriasis? Lancet 2012; 380: 708-9. BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:40 Pagina 111