Evidence-based recommendations on conventional systemic treatments in psoriasis: systematic review and expert opinion of a panel of dermatologists

摘要: Background  There is a high level of heterogeneity regarding the practical use conventional systemic treatment in psoriasis. Objectives  The aim this study was to develop evidence-based recommendations for traditional treatments psoriasis daily clinical practice: methotrexate (MTX), cyclosporin and retinoids. Methods  A scientific committee selected clinically relevant questions concerning MTX, retinoids psoriasis. This selection made using Delphi method. systematic literature search performed Medline, Embase Cochrane Library. articles analysis were reviewed evidence appraised according Oxford Levels Evidence. An Expert consensus meeting took place June 2010, including 66 dermatologists. Recommendations during interactive workshops where reviewed. Agreement among participants impact on practice systematically assessed voting procedure plenary session. Results  total 2800 references identified, which 122 included reviews. Three key MTX formulated, optimal dosage route, folic acid, risk factors liver fibrosis monitoring hepatotoxicity. focused modalities prescription: dosage, scheme treatment, duration renal toxicity non-plaque (erythrodermic, pustular ungueal). also efficacy safety (mainly acitretin) plaque psoriasis. Conclusions  These therapies are based supported by panel next step will be disseminate these assess agreement physicians who not involved generating recommendations.