Dermatology Handbook
For UK audiences

The essential guide to product selection

DH
Acitretin (Neotigason)
Systemic psoriasis treatments Teva

Acitretin (Neotigason)

Acitretin is a retinoid. Retinol (Vitamin A) is known to be essential for normal epithelial growth and differentiation, though the mode of this effect is not yet established. Both retinol and retinoic acid are capable of reversing hyperkeratotic and metaplastic skin changes. However, these effects are generally only obtained at dosages associated with considerable local or systemic toxicity. Acitretin, a synthetic aromatic derivative of retinoic acid, has a favourable therapeutic ratio, with a greater and more specific inhibitory effect on psoriasis and disorders of epithelial keratinisation. The usual therapeutic response to acitretin consists of desquamation (with or without erythema) followed by more normal re-epithelialisation. Acitretin is the main active metabolite of etretinate.

Indications

Treatment of severe extensive psoriasis, which is resistant to other forms of therapy, palmo-plantar pustular psoriasis, severe congenital ichthyosis and severe Darier’s disease (keratosis follicularis)

Price

  • 10mg (60), £CS
  • 25mg (60), £CS

Systemic psoriasis treatments

All Systemic psoriasis treatments
Adalimumab (Amgevita)
Amgen

Adalimumab (Amgevita)

Biosimilar of adalimumab (Humira).
Adalimumab (Hyrimoz)
Sandoz

Adalimumab (Hyrimoz)

Biosimilar of adalimumab (Humira).
Etanercept (Erelzi)
Sandoz

Etanercept (Erelzi)

Biosimilar of etanercept (Enbrel).
Infliximab (Zessly)
Sandoz

Infliximab (Zessly)

Biosimilar of infliximab (Remicade).
Ixekizumab (Taltz)
Lilly

Ixekizumab (Taltz)

Ixekizumab is an IgG4 monoclonal antibody that binds with high affinity (<3 pM) and specificity to interleukin 17A (both IL-17A and IL-17A/F). Elevated concentrations of IL-17A have been implicated in the pathogenesis of psoriasis by promoting keratinocyte proliferation and activation, as well as in the pathogenesis of psoriatic arthritis by driving inflammation leading to erosive bone damage and pathological new bone formation. Neutralisation of IL-17A by ixekizumab inhibits these actions.
Secukinumab (Cosentyx)
Novartis

Secukinumab (Cosentyx)

Secukinumab is a fully human IgG1/k; monoclonal antibody that selectively binds to and neutralises the proinflammatory cytokine interleukin-17A (IL-17A). Secukinumab works by targeting IL-17A and inhibiting its interaction with the IL-17 receptor, which is expressed on various cell types including keratinocytes. As a result, secukinumab inhibits the release of proinflammatory cytokines, chemokines and mediators of tissue damage and reduces IL-17A-mediated contributions to autoimmune and inflammatory diseases. Clinically relevant levels of secukinumab reach the skin and reduce local inflammatory markers. As a direct consequence treatment, secukinumab reduces erythema, induration and desquamation present in plaque psoriasis lesions.