العلاج الجهازي الفموي من الخط الأول لمرض الصداف المتوسط إلى الشديد

References

DOI: 10.1016/j.jaad.2020.02.044

• Methotrexate is recommended for the treatment of moderate to severe psoriasis in adults.
• Methotrexate can be administered orally or subcutaneously.
• Administration of folic acid or folinic acid is recommended to reduce the incidence of GI and hepatic adverse effects.
• Apremilast is recommended for the treatment of moderate to severe psoriasis in adults.
• For patients with severe renal impairment (creatinine clearance <30 mL/min), the dose of apremilast should be reduced to 30 mg once daily.
• Acitretin can be recommended as monotherapy for plaque psoriasis.
• Tofacitinib can be considered for treatment of moderate to severe psoriasis but is not currently FDA approved for that indication.
• Dimethyl fumarate is approved in the United States for treatment of relapsing forms of multiple sclerosis. It can be recommended for psoriasis.