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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A clinical cooperative study involving 14 centers evaluated photochemotherapy (psoralen and high-intensity long-wave ultraviolet light [PUVA]) for psoriasis. Results from 465 patients treated with a PUVA-48 unit (equipped with 48 high-intensity UVA bulbs) and 110 patients treated with a PUVA-64 unit (equipped with 64 high-intensity UVA bulbs) confirmed the effectiveness of photochemotherapy for psoriasis. Clearing of psoriasis occurred in 85% of patients on PUVA-48 therapy. Mean number of treatments, joules per square centimeter, to clear, and total joules at clearing were similar to other reported trials. The plateau method of clearing resulted in lower joules per square centimeter at clearing, total joules per square centimeter, and number of treatments than the nonplateau method. Maintenance therapy groups were mainly M1 (once weekly) or M4 (no treatment for more than 60 days). No meaningful laboratory abnormalities were detected and ophthalmologic examinations showed a few abnormal results following PUVA. Short-term side effects were mainly erythema, nausea, and pruritus. The effectiveness and short-term safety of PUVA for psoriasis has now been confirmed by a second large cooperative study.
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PMID:Photochemotherapy for psoriasis. A clinical cooperative study of PUVA-48 and PUVA-64. 37 39

The efficacy of orally administered mycophenolic acid (MPA), an inhibitor of guanosine monophosphate (GMP) synthesis, for the treatment of psoriasis, was studied in a double-blind fashion. Of twenty-one patients completing the study period, ten of eleven patients treated with MPA had a greater than 25% decrease in severity score compared with only two of ten patients treated with placebo. The placebo group had a slight increase in severity score compared to almost 50% reduction in the average severity score of the MPA-treated group. After termination of the double-blind portion of the study, the placebo group was treated with MPA and showed a 60% decrease in severity score. Adverse effects encountered included anorexia, nausea, vomiting, and diarrhea. One patient had an uncomplicated episode of herpes zoster. Other than a mild decrease hemoglobin, no hematologic toxicity was noted.
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PMID:Efficacy of mycophenolic acid for the treatment of psoriasis. 39 32

One hundred and seven patients with psoriasis underwent initial PUVA therapy. Complete clearance was obtained in 52.3% of the patients, incomplete in 40.2% while 7.5% of the patients did not respond at all. The non-responders to the regular PUVA treatment regime (0.5 mg 8-MOP/kg body-weight) were given an increased 8-MOP (8-methoxypsoralen) dose schedule (0.6 mg 8-MOP/kg body weight) and in 90.9% of these patients their lesions cleared after 35 PUVA exposures. However, a small percentage (9.1%) of the non-responders to the normal dose schedule did not want to continue the increased 8-MOP dose schedule because of persistent nausea. For this reason they were given regular PUVA therapy and they reacted well, but only after fifty-five exposures. Irrespective of the complete or incomplete clearance of psoriasis the patients remained in remission for a mean period of about 5 1/2 months. During the remission period the patients were advised to use a tar preparation or topical corticosteroids in the event of minor exacerbations.
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PMID:Initial photochemotherapy of psoriasis with orally administered 8-methoxypsoralen and longwave ultraviolet light (PUVA). 43 82

5-Methoxypsoralen (5-MOP, Bergapten) was evaluated as a potential photosensitizing drug in oral photochemotherapy of psoriasis. Treatment results indicate that (1) 5-MOP is as effective as, and in high doses more effective than, 8-methoxypsoralen in clearing psoriatic lesions; (2) therapeutic doses of 5-MOP do not lead to erythema; the acute side-effects of 8-MOP PUVA therapy--erythema, blistering, pruritus--are thus avoided; (3) even high doses of 5-MOP are not followed by nausea. 5-MOP PUVA therapy thus represents a real alternative to 8-MOP PUVA, its advantages over 8-MOP PUVA being greater safety and patient acceptance.
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PMID:5-Methoxypsoralen (Bergapten) in photochemotherapy of psoriasis. 50 4

Thirty five patients with psoriasis (plaque type 26, guttate 3, pustular 4, and erythrodermic 2) were treated with oral mycophenolic acid for a period ranging from 52 to 104 weeks. The average follow-up was 89 weeks, and the dose schedule ranged from 2,400 to 7,200 mg daily. Excellent response was noted in 20 patients, good in 13 patients, and poor in 2. The most common clinical side effects were in the gastrointestinal tract, namely, diarrhea, nausea, abdominal cramps, and soft stools. A high incidence of herpes simplex, herpes zoster, and a flu-like syndrome was noted. Laboratory abnormalities consisted of mild blood hemoglobin reduction, one case of leukopenia (3,9000 WBCs per cubic millimeter), two cases with thrombocytopenia and mild elevation of alkaline phosphatase. Mycophenolic acid appears as a promising drug for the treatment of severe psoriasis.
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PMID:Mycophenolic acid in the treatment of psoriasis: long-term administration. 87 14

Mycophenolic acid (MPA), an inhibitor of purine synthesis, was evaluated for its therapeutic and adverse effects in 29 patients with psoriasis. MPA was administered orally for at least 12 weeks, during which time the daily dose was increased from 1600 to 4800 mg depending on occurrence of adverse reactions. Complete clearing occurred in 1 of the patients, almost complete clearing in 14, definite improvement in 13, slight or doubtful improvement in 1. The full effect of MPA required a median time of 8 weeks (range 5-14). After discontinuing MPA, relapses began at a median time of 4 weeks (range 3-8). The severity of psoriasis was scored on a 0 to 108 scale using a newly devised system. The mean severity and range before treatment was 47 (21-88); after 12 weeks, 15 (0-50). Adjustment of dose on the basis of side effects resulted in a median daily dose of 3600 mg (range 2400-4800 mg; 30-96 mg/kg ideal weight). Characteristic dose-limiting side effects were soft or frequent bowel movements, diarrhea, nausea, and anorexia. One instance of reversible, dose-related leukopenia was identified.
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PMID:Treatment of psoriasis with oral mycophenolic acid. 119 17

5-methoxypsoralen (5-MOP) is considered an alternative to 8-methoxypsoralen (8-MOP) for photochemotherapy of psoriasis. We have compared the clinical efficacy and tolerability of 5-MOP (1.2 mg/kg)-UVA versus 8-MOP (0.6 mg/kg)-UVA therapy in 25 patients of skin type III and IV, affected by relapsing plaque-type psoriasis of similar body involvement; indeed, the same patients were given 8-MOP during 1 year and 5-MOP during the subsequent year after relapsing. Both treatments cleared psoriatic lesions with a comparable number of exposures, but 5-MOP required significantly higher cumulative UVA doses. The difference was due to the lower phototoxicity of 5-MOP, as assessed by the determination of the minimal phototoxic dose, and to its higher tanning activity, as assessed by the weekly grading of pigmentation. Nevertheless, therapy by 5-MOP-UVA seemed particularly interesting in that it showed a higher tolerability since only 1 patient experienced nausea, whereas during therapy with 8-MOP-UVA nausea and/or vomiting occurred in 7 patients, sunburn in 6 and itching in 3. Since we have treated the same patients with the two drugs, our results were not influenced by interindividual variations of phototoxic responses, tanning ability and susceptibility to develop psoralen-induced short-term side-effects. It was concluded that, although long-term side-effects of the 5-MOP-UVA treatment have still to be determined, such treatment of psoriasis should be reappraised due to its higher tolerability in comparison to 8-MOP-UVA treatment.
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PMID:A reappraisal of the use of 5-methoxypsoralen in the therapy of psoriasis. 136 9

Thirty-nine patients with psoriasis undergoing PUVA participated in a prospective double-blind study of acute non-phototoxic adverse effects comparing the liquid formulations of 8-methoxypsoralen (0.6 mg/kg) and 5-methoxypsoralen (1.2 mg/kg). A much higher number of patients experienced nausea (8-MOP = 51.3%, 5-MOP = 7.7%) and pruritus (8-MOP = 71.8%, 5-MOP = 43.6%) than has been reported for crystalline tablets. No attempt was made to compare therapeutic efficacy between liquid and crystalline tablet formulations or between 8-MOP and 5-MOP, which both appeared to be effective. The high incidence of adverse effects suggests that current dosage recommendations be reviewed.
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PMID:Liquid formulations of 8-methoxypsoralen (8-MOP) and 5-MOP: a prospective double-blind crossover assessment of acute non-phototoxic adverse effects. 139 Jan 21

Forty-four patients with chronic plaque psoriasis were randomly allocated to treatment with bath-water-delivered 8-methoxypsoralen (bath 8-MOP) or oral 8-methoxypsoralen (oral 8-MOP) PUVA therapy. There was a significant reduction in extent of the lesions and psoriasis area and severity index (PASI) after 20 treatments with each modality. There was a fourfold reduction in cumulative ultraviolet A (UVA) dose in the bath group. Side-effects of erythema and nausea were less with bath therapy.
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PMID:Bath-water compared with oral delivery of 8-methoxypsoralen PUVA therapy for chronic plaque psoriasis. 141 60

Forty patients with psoriasis treated with methotrexate (MTX) are reviewed. MTX was particularly effective in controlling erythrodermic and generalized pustular psoriasis. The treatment was discontinued in seven patients due to nausea in two and because of abnormal laboratory tests in five. Two patients developed toxic epidermal necrolysis (TEN) and died. Patients under 60 years of age had a liver biopsy before treatment and repeat biopsy after each cumulative MTX dose of 1500 mg. We consider that MTX is the drug of choice for treating difficult psoriasis.
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PMID:The efficacy of methotrexate in psoriasis--a review of 40 cases. 145 15


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