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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Change of treatment from cyclosporin to mycophenolate mofetil in severe psoriasis

S C Davison1, R Morris-Jones, A V Powles

  • 1Department of Dermatology, St. Mary's Hospital, Praed Street, London W2 1NY, UK.

The British Journal of Dermatology
|August 22, 2000
PubMed

Insights

Mycophenolate mofetil (MMF) showed less efficacy than cyclosporin for severe psoriasis control in a small patient group. However, MMF improved renal function in patients with cyclosporin-induced nephrotoxicity.

Area of Science:

  • Dermatology
  • Nephrology
  • Immunosuppression

Background:

  • Long-term cyclosporin use for severe psoriasis can lead to nephrotoxicity and hypertension.
  • Alternative immunosuppressants are needed for patients intolerant to cyclosporin.

Purpose of the Study:

  • To evaluate the efficacy and safety of switching from long-term cyclosporin to mycophenolate mofetil (MMF) in patients with severe psoriasis.

Main Methods:

  • Eight patients with severe psoriasis on long-term cyclosporin were switched to MMF.
  • Reasons for switching included nephrotoxicity (n=7) and lack of efficacy/hypertension (n=1).
  • Psoriasis control and renal function were monitored post-switch.

Main Results:

  • Psoriasis control significantly deteriorated in 5 patients and slightly in 3.
  • Renal function improved in 6 of 6 patients with pre-existing nephrotoxicity after >2 weeks on MMF.
  • MMF provided reasonable disease control in 3 of 8 patients.

Conclusions:

  • Mycophenolate mofetil (MMF) appears less effective than cyclosporin for severe psoriasis control.
  • MMF may be a viable alternative for patients with psoriasis who cannot tolerate cyclosporin due to renal toxicity.
  • MMF demonstrated potential for improving renal function in patients with prior cyclosporin-induced nephrotoxicity.

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