Cyclosporin in psoriasis: continuous monotherapy versus intermittent long-term therapy.
Using two methods (continuous monotherapy and intermittent therapy) for the treatment of psoriasis with cyclosporine, we observed the clinical efficacy and adverse reactions of each treatment method for more than 36 months to evaluate the clinical usefulness of both methods. Thirty-seven cases were analyzed and the following results were obtained: 1) The PASI score evaluated at each visit was maintained between 5 and 10 by both treatment methods and the improvement rate was more than 70%, while there was no difference in the daily dose between the two treatment methods; 2) The period required to achieve remission tended to be prolonged by intermittent therapy, while no change was observed with continuous monotherapy; 3) The period up to relapse tended to become shorter with both treatment methods but this tendency was more marked with intermittent therapy; 4) E-PAP(evaluation for prognosis with averaged PASI) was lower in the continuous monotherapy group and the patients were more satisfied; 5) The incidence of adverse reactions was similar to that reported in previous studies, with no difference between the two treatment methods in this regard; 6) A significant increase in BUN levels was observed in elderly patients; 7) There were only three cases in which the drug was discontinued due to exacerbation and adverse reactions. Based on the above findings, continuous monotherapy seems to be of greater clinical usefulness than intermittent therapy.
Ozawa
A
A
Department of Dermatology, Tokai University School of Medicine, Bohseida, Isehara, Kanagawa, Japan 259-1193, USA. ozawa@is.icc.u-tokai.ac.jp
Sugai
J
J
Ohkido
M
M
Ohtsuki
M
M
Nakagawa
H
H
Kitahara
H
H
Tamaki
K
K
Urabe
K
K
Nakayama
J
J
Horikoshi
T
T
Morimoto
Y
Y
Jimbow
K
K
D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction; D013995:Time; D016896:Treatment Outcome
D003879:Dermatologic Agents; D016572:Cyclosporine