Efficacious treatment of psoriasis with low-dose and intermittent cyclosporin microemulsion therapy

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Cyclosporin is a recognized treatment for moderate to severe psoriasis.
• Improving the safety profile of cyclosporin is crucial for long-term patient management.
• Psoriasis Area and Severity Index (PASI) is a standard measure for assessing disease severity.

Purpose of the Study:

• To evaluate the efficacy and safety of a low-dose, intermittent cyclosporin microemulsion regimen for psoriasis vulgaris.
• To determine the effectiveness of a cyclical treatment approach involving cessation and restart of cyclosporin.
• To assess treatment outcomes over a 96-week period.

Main Methods:

• Seventy-three patients with moderate to severe psoriasis vulgaris received cyclosporin microemulsion at approximately 2.5 mg/kg/day.
• Treatment continued until a 75% reduction in PASI score was achieved.
• A cyclical approach was employed, restarting treatment upon relapse (PASI < 50% reduction).

Main Results:

• An average of 49.8 days was needed for initial PASI 75% reduction.
• Twenty patients required a second course of cyclosporin, with a mean interval of 94 days.
• The second course required an average of 60.8 days to achieve PASI 75% reduction, similar to the first course.
• Only six patients required continuous treatment for 96 weeks.
• One case of hypertension was reported as an adverse effect.

Conclusions:

• Low-dose, intermittent cyclosporin microemulsion is an effective treatment for moderate to severe psoriasis vulgaris.
• This regimen demonstrates a favorable safety profile, with limited adverse events.
• The cyclical administration allows for sustained disease control while potentially minimizing cumulative toxicity.