Clinical pharmacokinetics and pharmacodynamics of oral systemic nonbiologic therapies for psoriasis patients.

Justin M Eichinger, Divya M Shan, Jonathan D Greenzaid, Lisa Anakwenze, Steven R Feldman
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Abstract

Introduction: Psoriasis is a chronic inflammatory immune condition. Treatments for psoriasis vary with disease severity, ranging from topicals to systemic biologic agents. The pharmacokinetic (PK) and pharmacodynamic (PD) properties of these therapies establish drug efficacy, toxicity, and optimal dosing to ensure therapeutic drug levels are sustained and adverse effects are minimized.

Areas covered: A literature search was performed on PubMed, Google Scholar, and Ovid MEDLINE for PK and PD, efficacy, and safety data regarding oral systemic nonbiologic therapies utilized for moderate-to-severe plaque psoriasis. The findings were organized into sections for each drug: oral acitretin, methotrexate, cyclosporine, apremilast, tofacitinib, and deucravacitinib.

Expert opinion: Some psoriasis patients may not respond to initial therapy. Ongoing research is evaluating genetic polymorphisms that may predict an improved response to specific medications. However, financial and insurance barriers, as well as limited genetic polymorphisms correlated with treatment response, may restrict the implementation of genetic testing necessary to personalize treatments. How well psoriasis patients adhere to treatment may contribute greatly to variation in response. Therapeutic drug monitoring may help patients adhere to treatment, improve clinical response, and sustain disease control.

银屑病患者口服系统非生物疗法的临床药代动力学和药效学。
导言银屑病是一种慢性免疫炎症。银屑病的治疗方法因病情严重程度而异,从局部外用药到全身生物制剂,不一而足。这些疗法的药代动力学(PK)和药效学(PD)特性决定了药物的疗效、毒性和最佳剂量,以确保维持治疗药物水平并将不良反应降至最低:我们在 PubMed、Google Scholar 和 Ovid MEDLINE 上进行了文献检索,以了解与治疗中度至重度斑块状银屑病的口服系统性非生物疗法有关的 PK 和 PD、疗效和安全性数据。研究结果按每种药物分为几个部分:口服阿曲替汀、甲氨蝶呤、环孢素、阿普瑞米拉司特、托法替尼和去曲替尼:有些银屑病患者可能对初始治疗无效。正在进行的研究正在评估基因多态性,这些基因多态性可能预示着对特定药物的反应会有所改善。然而,经济和保险方面的障碍以及与治疗反应相关的基因多态性有限,可能会限制个性化治疗所需的基因检测的实施。银屑病患者坚持治疗的程度可能在很大程度上导致治疗反应的差异。治疗药物监测可帮助患者坚持治疗,改善临床反应,维持疾病控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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