Korean J Dermatol.  2023 May;61(4):226-232.

Treatment Outcomes of Oral Acitretin versus Alitretinoin for Psoriasis: A Retrospective Review of 65 Cases

• Kim KY
• Choi YJ
• Lee GY

Abstract

Background
Oral acitretin (ACT) has been approved for the treatment of psoriasis (PSO), whereas alitretinoin (ALI) has been prescribed off-label. Few studies have compared the efficacy of these two therapeutics.
Objective
To evaluate the clinical outcomes of oral ACT versus ALI for treating PSO.
Methods
Sixty-five patients diagnosed with PSO and treated with ACT or ALI were reviewed. Patient demographics, clinical efficacy, and adverse effects were evaluated. Treatment efficacy was assessed using physician’s global assessment (PGA) and psoriasis area and severity index (PASI).
Results
A total of 38 cases in the ACT group and 27 cases in the ALI group in PSO were retrospectively reviewed. No significant intergroup differences were noted in the proportion of patients achieving PGA score of “clear” or “almost clear” (18.42% vs. 22.22%; p=0.71). The reduction rate of PASI from baseline was higher in the ALI group (24.30% vs. 22.74%; p=0.68), while the rate of achieving 75% improvement in PASI was higher in the ACT group (18.42% vs. 14.81%; p=0.75); no significantly differences were noted. The ALI group had fewer adverse effects (6/27 [22.22%]) than the ACT group (10/38 [26.32%]), and no severe events occurred in either group.
Conclusion
ALI can be considered an off-label treatment option for a limited patient population.

Keyword

Acitretin; Alitretinoin; Psoriasis; Treatment outcome