A systematic review of treatments for severe psoriasis

Griffiths C E M, Clark C M, Chalmers R J G, Li Wan Po A, Williams H C
Record ID 32001000060
Authors' objectives:

This systematic review of the evidence base aims to compare the effectiveness of currently available treatments for severe psoriasis and identify areas in need of further research.

Authors' recomendations: Although the availability of RCTs has dictated that this report deal exclusively with systemic treatments and phototherapies, it is important to be aware that patients with severe psoriasis are frequently treated by means of inpatient or day-treatment centre management (e.g. topical dithranol combined with UVB phototherapy), for which there are no published RCTs. Thus, the recommendation of systemic therapies should not preclude traditional inpatient or day-treatment centre management. The findings show that there is firm RCT evidence of the effectiveness of some systemic treatments for severe chronic plaque psoriasis, specifically: - cyclosporin - systemic retinoids (acitretin and etretinate), especially in combination with PUVA - photochemotherapy and phototherapy (PUVA, broadband UVB and narrowband UVB) - combinations of topical vitamin D3 analogues and topical steroids with either photochemotherapy or phototherapy - fumarates. There is a lack of firm RCT evidence for other treatments for severe chronic plaque psoriasis, including: - methotrexate, although this widely used treatment was introduced prior to the advent of RCT evidence - hydroxyurea - azathioprine - sulphasalazine, although one RCT showed moderate efficacy.
Authors' methods: Systematic review
Project Status: Completed
URL for project: http://www.hta.ac.uk/1036
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Phototherapy
  • Psoriasis
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.