• Hyun Sun Yoon and Jai Il Youn.
• Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
• J Dermatolog Treat. 2007 Jan 1; 18 (5): 286-90.

BackgroundFew reports have been issued which compare the efficacy and tolerability of cyclosporine dose adjustments before 12 weeks of treatment.ObjectiveTo compare the efficacy and tolerability of two different dosage regimens of cyclosporine in severe psoriasis.MethodsThis 12-week, prospective, open-label study included 61 severe psoriasis patients. Patients were assigned to a 2.5 mg/kg per day starting dose and an increasing regimen ('standard regimen') or a 5.0 mg/kg per day starting dose and a decreasing regimen ('step-down regimen') group. The end point included 50% and 75% reductions in Psoriasis Area and Severity Index (PASI) scores. Adverse events were also evaluated.ResultsAccording to a 50% PASI reduction (PASI 50), the response rate at 12 weeks was similar for two groups. The percentage of patients achieving a 75% PASI reduction (PASI 75) at 12 weeks was higher in the step-down regimen group. The mean time to PASI 50 or PASI 75 was shorter in the step-down regimen group. No difference was found between the two groups in terms of the number of patients with adverse events requiring intervention.ConclusionThis study suggests that the 'step-down' cyclosporine regimen offers an effective and safe therapeutic option for the management of severe psoriasis.

21 keywords...

hide…