title: Efficacy and safety of preprandial versus postprandial administration of low-dose cyclosporin microemulsion (Neoral) in patients with psoriasis vulgaris.
abstract: A study of therapeutic drug monitoring indicated that cyclosporin administered before meals produces higher blood concentrations than an equivalent dose administered after meals. Our objective was to compare the efficacy of cyclosporin administered before and after meals, respectively, in psoriasis vulgaris patients. We performed an open trial study. Patients were randomly assigned to receive cyclosporin before (group B, n = 20) or after meals (group A, n = 17), and were followed up in 10 dermatology clinics. The difference between groups was evaluated in severity. The percent reduction in psoriasis area and severity index score from baseline was 29.8% in group A and 75.4% in group B (A vs B, P = 0.00005). Two patients in each group withdrew due to abnormality of laboratory data. Short-term, low-dose treatment with cyclosporin before rather than after meals is suggested as a new effective treatment regimen for psoriasis, with the added advantage of lowering costs.
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan. hihashiz@hama-med.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Hashizume
authors.forename: Taisuke
authors.initials: T
authors.lastname: Ito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yagi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takigawa
authors.forename: Hazuki
authors.initials: H
authors.lastname: Kageyama
authors.forename: Fukiko
authors.initials: F
authors.lastname: Furukawa
authors.forename: Maki
authors.initials: M
authors.lastname: Hata
authors.forename: Shigeho
authors.initials: S
authors.lastname: Shirahama
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.forename: Teruomi
authors.initials: T
authors.lastname: Higashishiba
authors.forename: Hideki
authors.initials: H
authors.lastname: Machida
authors.forename: Tomoo
authors.initials: T
authors.lastname: Tsushima
authors.forename: Kayo
authors.initials: K
authors.lastname: Matsushita
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D004655:Emulsions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010865:Pilot Projects; D019518:Postprandial Period; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine