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December 1976

Anemia of Azaribine in the Treatment of Psoriasis

Author Affiliations

From the Divisions of Dermatology, Scripps Clinic and Research Foundation, La Jolla, Calif (Drs Cornell and Stoughton); University of California, San Diego, Calif (Dr Milstein); and Department of Medicine, Monash University, Melbourne (Dr Fox).

Arch Dermatol. 1976;112(12):1717-1723. doi:10.1001/archderm.1976.01630370005001

• Azaribine is an effective agent in the treatment of psoriasis. In this investigation the extent of clinical dermatologic remission appeared to correlate with the degree of metabolic block induced by 6-azauridylic acid, as quantitated by the urinary excretion of orotic acid and orotidine, and the development of anemia.

Following azaribine therapy there was a coordinate rise of the specific activities of erythrocyte orotate phosphoribosyltransferase and orotidine-5′-monophosphate decarboxylase. There was no correlation between the pretreatment activity of these enzymes and the clinical response to azaribine.

The anemia of azaribine therapy was mild and of a megaloblastic type. Uridine effectively corrected the azaribine-induced anemia, but led to exacerbation of the patients' psoriasis. Following uridine therapy there was a reduction in the urinary excretion of orotic acid and orotidine, presumably reflecting end-product inhibition or repression of the first steps of a repeated pyrimidine biosynthesis.

(Arch Dermatol 112:1717-1723, 1976)

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