Ciclosporin in psoriasis clinical practice: an international consensus statement.
The main recommendations for the use of ciclosporin in the management of psoriasis are: (i) intermittent short courses (average of 12 weeks duration) of ciclosporin are preferable; (ii) ciclosporin should be given in the dose range 2.5-5.0 mg kg(-1) day(-1) (doses greater than 5.0 mg kg(-1) day(-1) should only be given in exceptional circumstances); (iii) treatment regimens should be tailored to the needs of each patient; (iv) selection of patients should take into account psychosocial disability, as well as clinical extent of disease and failure of previous treatment; (v) each patient's renal function (as measured by serum creatinine) should be thoroughly assessed before and during treatment; (vi) each patient's blood pressure should be carefully monitored before and during treatment; (vii) adherence to treatment guidelines substantially reduces the risk of adverse events; (viii) long-term continuous ciclosporin therapy may be appropriate in a subgroup of patients; however, duration of treatment should be kept below 2 years whenever possible; and (ix) when long-term continuous ciclosporin therapy is necessary, annual evaluation of glomerular filtration rate may be useful to accurately monitor renal function.
Griffiths
C E M
CE
Skin Research Institute and Dermatology, Saint Louis University Hospital, Paris, France. christopher.griffiths@man.ac.uk
Dubertret
L
L
Ellis
C N
CN
Finlay
A Y
AY
Finzi
A F
AF
Ho
V C
VC
Johnston
A
A
Katsambas
A
A
Lison
A-E
AE
Naeyaert
J M
JM
Nakagawa
H
H
Paul
C
C
Vanaclocha
F
F
D032921:Consensus; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000139:chemically induced; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine