Cyclosporine therapy for psoriasis: a cell cycle-derived dosing schedule.
BACKGROUND
Cyclosporine is effective in the treatment of psoriasis; however, potentially serious side effects limit its long-term use. On the basis of the 36-hour psoriatic keratinocyte cell cycle, a new dosing regimen was investigated.


OBJECTIVE
The purpose of this study was to evaluate a 36-hour weekly dosing schedule with cyclosporine for the treatment of psoriasis, in an attempt to decrease side effects while maintaining efficacy.


METHODS
Fifteen patients were studied by means of oral doses of cyclosporine taken at 12-hour intervals for three doses per week during a 10-week period. The initial dose, 2.5 mg/kg/dose (7.5 mg/kg/wk), was increased every 2 weeks by 2.5 mg/kg/dose to a maximum of 10 mg/kg/dose.


RESULTS
The average improvement as assessed by the Psoriasis Area and Severity Index for all 15 patients was 61%. Six patients had a more than 75% improvement, three patients improved 50% to 74%, and six patients improved less than 50%. Three patients dropped out because of adverse side effects, and three others completed the study at a reduced dose.


CONCLUSIONS
It is concluded that, although effective, this dosing regimen may not have an advantage over daily dosing, given its side effect profile and the need to go to relatively high doses every 24 hours.
Goodman
M M
MM
Department of Dermatology, University of California, Irvine.
White
G M
GM
McCormick
A
A
McCullough
J
J
Weinstein
G
G
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001830:Body Surface Area; D002453:Cell Cycle; D002985:Clinical Protocols; D003404:Creatinine / Q000652:urine; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010292:Paresthesia / Q000139:chemically induced; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction
D016572:Cyclosporine; D003404:Creatinine