Am J Clin Dermatol. 2013 Feb;14(1):9-25. doi: 10.1007/s40257-012-0003-7.
Gustafson CJ, Watkins C, Hix E, Feldman SR.
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA.
BACKGROUND: Psoriasis is a chronic, systemic, inflammatory condition for which a variety of treatment modalities exist. Combinations of therapies are used often in clinical practice to enhance efficacy and reduce drug toxicities.
PURPOSE: The purpose of this review is to assess the literature on the efficacy and safety of combination therapy in the treatment of psoriasis.
METHODS: MEDLINE was reviewed to identify English-language publications from 1966 to 2011 examining combination therapy in psoriasis. Fifty-three articles met inclusion criteria and were included in this review. Randomized controlled trials addressing various combinations of treatment modalities for psoriasis were included. Data from these clinical studies were summarized and the outcomes were discussed.
RESULTS: Large-scale, randomized controlled trials investigating the use of various combination therapies in psoriasis are limited. The strongest data support the use of combinations of vitamin D derivatives and corticosteroids as topical combinations and, to a lesser extent, the combination of other topical agents. Phototherapy and topical vitamin D derivatives as well as phototherapy in combination with oral retinoids are well supported in the literature. Combinations of systemic medications, though often used clinically, have little data to support their efficacy or safety.
LIMITATIONS: Our data were limited by the small number of clinical trials examining the multiple available combinations that are used in clinical practice.
CONCLUSIONS: The use of combination treatments falls within the standard of care for psoriasis, even if these combinations have not been extensively studied in clinical trials.
- All items in category Psoriasis and Vitamin D
- Psoriasis, metabolic syndrome, and vitamin D – 2011
- Psoriasis best treated by combinations such as vitamin D and UVB – meta-analysis Dec 2011
- Efficacy of localized phototherapy and photodynamic therapy for psoriasis: a systematic review and meta-analysis Dec 2013
Primarily psoralen plus ultraviolet A (PUVA), Vitamin D hardly mentioned.
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- Diet and psoriasis, part III: Role of nutritional supplements April 2014 no details in abstract
Patients often inquire about what dietary supplements may be beneficial, including the use of oral vitamin D, vitamin B12, selenium, and omega-3 fatty acids in fish oils