Cyclosporine in severe psoriasis. Results of a meta-analysis in 579 patients.
OBJECTIVE
A meta-analysis of 3 major German studies conducted between 1989 and 1994 with cyclosporine in severe psoriasis was performed to allow an integrated evaluation of the efficacy and tolerability of cyclosporine in this indication.


METHODS
All 3 studies were prospective, randomized, parallel group studies. The studies were conducted in 61 dermatologic centers in Germany.


METHODS
The studies involved 597 patients with severe plaque type psoriasis. Treatment consisted of cyclosporine (at a dosage of 1.25, 2.5 or 5 mg/kg/day), etretinate (at a mean daily dose of 0.53 mg/kg/day) or placebo in a total of 756 treatment cycles with a maximum duration of 12 weeks.


METHODS
The main outcome measures were the psoriasis area and severity index (PASI) and serum creatinine level.


RESULTS
The meta-analysis revealed that cyclosporine given in a dosage of 2.5 and 5 mg/kg/day was significantly superior to etretinate. In addition cyclosporine 1.25 mg/kg/day proved to be significantly more effective than placebo. An increase in serum creatinine level that required intervention occurred in 3.4% of cyclosporine treatment cycles.


CONCLUSIONS
Cyclosporine is highly effective and well tolerated in the short term treatment of severe psoriasis.
Faerber
L
L
Department of Pharmacology, University of Regensburg, Regensburg, Germany.
Braeutigam
M
M
Weidinger
G
G
Mrowietz
U
U
Christophers
E
E
Schulze
H J
HJ
Mahrle
G
G
Meffert
H
H
Drechsler
S
S
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index
D003879:Dermatologic Agents; D016572:Cyclosporine