Safety of long-term treatment with cyclosporin A in resistant chronic plaque psoriasis: a retrospective case series.
BACKGROUND
An intermittent short course of cyclosporin A (CyA) therapy is a good choice in the treatment of severe psoriasis. Nevertheless, some severe or resistant patients might benefit from long-term treatment. Adverse effects of long-term use of CyA are investigated and the results are compared with the literature.


METHODS
A retrospective study of adverse effects of CyA treatment in a group of 53 patients suffering from psoriasis. The mean treatment time was 31.4 +/- 23.2 months with a minimum of 4 months to a maximum of 95 months, with very few short interruptions of treatment (from 2 to 5 months in five patients).


RESULTS
The group consisted of 29 women and 24 men, ranging in age from 18 to 65 years, with an average age of 44.49 years. Arterial hypertension appeared in 45.3% of patients during treatment. Pharmacological treatment was required in 32% of these patients to control the condition. Serum creatinine levels were transiently elevated in 11.3% of the cases, but withdrawal of treatment was required in none of them.


CONCLUSIONS
Long-term CyA treatment might be necessary in some patients and this study shows that it could be sustained with a close follow-up. This involves regular visits depending on each patient, as well as common test protocol and clinical evaluation. In conclusion, this retrospective study seems to confirm the relative safety of long-term CyA treatment when patients are adequately monitored.
Servicio de Dermatología, Hospital Universitario de Canarias, Ofra, 38320 La Laguna, Tenerife, Spain. mgarciab@ull.es
M
M
García-Bustínduy
M
M
Escoda
F J
FJ
Guimerá
M
M
Sáez
S
S
Dorta
E
E
Fagundo
R
R
Sánchez-González
A
A
Noda-Cabrera
R
R
García-Montelongo
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012189:Retrospective Studies
D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine