关键词: 阿维A, 银屑病, 药物毒性, 停药原因

Abstract: 【Abstract】 Objective To analyze adverse drug reactions (ADR) and reasons for drug discontinuation during acitretin therapy in patients with psoriasis vulgaris. Methods A total of 292 patients with psoriasis vulgaris treated with acitretin were collected from the First Affiliated Hospital of Guangxi Medical University from 2014 to 2019. According to the inclusion and exclusion criteria, 193 patients who received periodic follow-up were included in this study, clinical data were collected from these patients and retrospectively analyzed. ADRs occurring during the acitretin treatment and reasons for drug discontinuation were analyzed. Results Totally, 519 cases of ADRs occurred in 171 of the 193 patients, with the incidence rate being 88.6%. Of these cases, 174 （33.5%） involved the epithelial tissues, 126 （24.3%） the endocrine system, 1 （0.2%） the reproductive system, 29 （5.6%） the motor system, 77 （14.8%） the circulatory system, 3 （0.6%） the nervous system, 71 （13.7%） the digestive system, and 38 （7.3%） involved the urinary system. Relatively common ADRs included dryness of skin and mucous membranes, as well as musculoskeletal pain, and common biochemical changes included dyslipidemia, elevated platelets, and abnormal aminotransferase levels. Most ADRs （81.6%） were reported within 1 month after the start of acitretin therapy. Rare ADRs included alopecia, tinnitus, paronychia, myasthenia, sensory abnormalities, headache, menstrual disorders and hyperbilirubinemia, which were mainly reported within 1 to 6 months after the start of therapy （70.6%）. Of the 519 cases of ADRs, 324 could be alleviated or subsided without drug intervention, 195 were alleviated or subsided after drug withdrawal and/or drug intervention, and there were no cases of serious illness or death. Among the 193 patients, 186 had discontinued acitretin therapy, of whom 116 （62.4%） discontinued due to improvement in disease condition, 35 （18.8%） discontinued due to ADR-induced poor medication compliance, 27（14.5%） discontinued under the guidance of clinicians due to ADRs, and 8 （4.3%） discontinued due to poor disease control. Conclusion The incidence of adverse reactions to acitretin is high in the treatment of psoriasis vulgaris, but most of them have a good prognosis.

Key words: Acitretin, Psoriasis, Drug toxicity, Reasons for drug discontinuation