Efficacy of low-dose cyclosporin A in psoriasis: results of dose-finding studies

Abstract

The efficacy of cyclosporin A (CyA) in severe psoriasis was analysed in 457 adult patients included in five European multicentre dose-finding studies. Initial CyA doses were 1.25 mg/kg/day in 33 patients, 2.5-3 mg/kg/day in 285 and 5 mg/kg/day in 139. After 3 months of treatment, the reduction of the Psoriasis Area and Severity Index (PASI) score was 35 +/- 6% with 1.25 mg/kg/day of CyA, 57 +/- 2% with 2.5 mg or 3 mg/kg/day and 86 +/- 2% with 5 mg/kg/day (P less than 0.001). The rates of success, defined by a PASI score reduction greater than or equal to 75% or a score less than or equal to 8, were 24%, 52% and 88%, respectively. There were no differences in age, initial severity or duration of psoriasis. The improvement was maintained for 9 months or more in the majority of patients receiving continuous CyA therapy.

Low-dose ciclosporin therapy of erythrodermic psoriasis

“…This case is noteworthy because we have observed clinical improvement at low doses of Cs alone. The degree of improvement in PASI scores was 85.3 % achieved comparatively late, which obtain with relatively low dose of Cs [3]. This case is negatory to papers reporting, that starting with dosages lower than 3.0 mg/kg daily may lead to insuficient efficacy [4] and strengthens reports suggesting minimising potentially harmful side-effects by treatment with initial daily oral dose of 2.5 -5.0 mg/kg daily, which may be modulated only in a case of insufficient efficacy [5][6][7].…”

The use of cyclosporine in dermatology: Part I

“…12 Subsequently, a multitude of dosefinding studies have been performed in order to elucidate the optimal and lowest effective dose of cyclosporine that achieves clearance with minimal toxicity. [13][14][15][16][17] Efficacy of cyclosporine is dose dependent, with a shorter time to remission at higher doses. 15,18 Benefit in efficacy gained by using doses higher than 5 mg/kg/day is, however, offset by an increase in toxicity.…”

Systemic Cyclosporin in the Treatment of Psoriasis

“…The efficacy of cyclosporin is dose-dependent, and times to psoriasis remission are shorter at higher doses (Faerber et al, 2001;Timonen et al, 1990). Results from key dose-finding studies and meta-analyses for cyclosporin in psoriatic patients are shown in www.intechopen.com was 16-88% (Christophers et al, 1992;Faerber et al, 2001;Timonen et al, 1990).…”

“…Results from key dose-finding studies and meta-analyses for cyclosporin in psoriatic patients are shown in www.intechopen.com was 16-88% (Christophers et al, 1992;Faerber et al, 2001;Timonen et al, 1990). Moreover, in a 16-week study in 85 patients with severe psoriasis, cyclosporin 3-7.5 mg/kg/day reduced global disease severity score by 59-77% (Ellis et al, 1991); however, although major, additional efficacy benefits can be obtained at cyclosporin doses >5 mg/kg/day, these benefits are offset by increased toxicity .…”