Abstract
Psoriasis is an immune-mediated disease of complex etiology. This article discusses four medications that “failed” for treatment of psoriasis, each for a different reason. Efalizumab “failed” because patients developed progressive multifocal leukoencephalopathy and the drug was taken off the market. Benoxaprofen was shown to be effective for psoriasis in several small trials. However, the medication was withdrawn from the market due to numerous side effects, including hepatic failure. CTLA4-Ig (abatacept) is currently approved for the treatment of adult rheumatoid arthritis and idiopathic juvenile arthritis and is effective for the treatment of psoriasis. However, a high dose is necessary and cost of the medication becomes prohibitive. In several studies, mycophenolic acid was shown to be effective for treating psoriasis. However, its use is limited because of a wide range of side effects. More specific treatments with fewer side effects should become available as our understanding of psoriasis continues to increase.
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