title: Quality of life improvement in treatment of psoriasis with intermittent short course cyclosporin (Neoral).
abstract: Due to concern over long term safety of continuous treatment with cyclosporin, the aim of this 1-year study was to assess the effect of intermittent therapy with cyclosporin (Neoral) on the quality of life of patients suffering from chronic plaque psoriasis. A total of 41 patients with chronic plaque psoriasis (26 male, mean age: 36 years, range: 18-61; duration of psoriasis 17 years, range: 2-31) entered a 9-centre open study in which cyclosporin was taken as an initial dose of 5 mg/kg/daily for a maximum of 12 weeks for up to three cycles. Each patient completed a psoriasis specific QOL measure (Psoriasis Disability Index, PDI) at the beginning and end of each treatment cycle and at the end of study. Clinical parameters including Psoriasis Area and Severity Index (PASI) were measured. The PDI scores showed a significant improvement (p < 0.01) between the beginning and end of all three treatment cycles. The various clinical assessments for each treatment period also showed significant improvement (p < 0.001) for all three cycles. When comparing the last follow-up value to baseline there was a clear indication of relapse, but these scores were still significantly better than at baseline (p < 0.01). Notably, the mean PASI score improved by more than 50% (p < 0.001) between first baseline and end of the study. These findings indicate that a short course of intermittent therapy with cyclosporin in microemulsion formulation, used at starting doses of 5 mg/kg/day, improves QOL of patients with chronic plaque psoriasis. Once again, the applicability and validity of the PDI as a useful QOL tool has been demonstrated.
authors.affiliation: Centre for Socioeconomic Research, University of Wales, Cardiff, UK. salekss@cardiff.ac.uk
authors.forename: M S
authors.initials: MS
authors.lastname: Salek
authors.forename: A Y
authors.initials: AY
authors.lastname: Finlay
authors.forename: J J C
authors.initials: JJ
authors.lastname: Lewis
authors.forename: M I
authors.initials: MI
authors.lastname: Sumner
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000188:drug therapy / Q000523:psychology; D016572:Cyclosporine / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000145:classification / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D003879:Dermatologic Agents; D016572:Cyclosporine