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A Treatment Strategy for Psoriasis: Transitioning From Systemic Therapy to Biologic Agents

Authors

  • Arisa Ortiz MD,

    1. From Albany Medical College, Albany, NY;1the David Geffen School of Medicine at UCLA, Los Angeles, CA;2 and the Dermatology Institute and Skin Care Center, Santa Monica, CA3
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  • and 1 Paul S. Yamauchi MD, PhD 2,3

    1. From Albany Medical College, Albany, NY;1the David Geffen School of Medicine at UCLA, Los Angeles, CA;2 and the Dermatology Institute and Skin Care Center, Santa Monica, CA3
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Paul S. Yamauchi, MD, PhD, 2001 Santa Monica Boulevard, Suite 490W, Santa Monica, CA 90404
E-mail: psyamauchi@earthlink.net

Abstract

Systemic agents such as methotrexate and cyclo-sporine are commonly used in the treatment of psoriasis. Long-term continuous use is not recommended due to potential organ toxicity, myelosuppression, and carcinogenicity. Abrupt cessation of systemic agents without tapering can lead to flare-up and rebound of psoriasis. The addition of a biologic agent during transitional therapy from a systemic agent is a good strategic maneuver to prevent a potential rebound complication. Even with a gradual cessation of systemic agents, the psoriasis will eventually relapse if biologic agents are not added to the treatment regimen. No additional toxicities or adverse events are evident during combination therapy with a systemic agent and a biologic agent.

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