A comparison of mycophenolate mofetil with ciclosporine for the treatment of chronic plaque-type psoriasis.
OBJECTIVE
To compare the efficacy of ciclosporine (CsA) versus mycophenolate mofetil (MMF) in psoriasis, a randomized trial was conducted.


METHODS
A prospective multicenter randomized open-label clinical trial was performed to compare two parallel groups of patients with chronic plaque psoriasis undergoing different treatments. Therefore, a total of 54 patients with psoriasis were randomly assigned to treatment with either CsA (2.5 mg/kg body weight) or MMF (2 g daily) for 12 weeks, and the drug doses were adjusted according to response. The psoriasis area and severity index (PASI) was used to assess the clinical severity of psoriasis. The primary outcome of this trial was the time to disease relapse. Safety, PASI scores and psoriasis disability index (PDI) were assessed as secondary outcome.


RESULTS
There was no difference in time to disease relapse between the two groups. After 12 weeks of treatment, the mean PASI score (+/-SD) decreased from 24.6 +/- 11.1 to 6.6 +/- 7.3 in the CsA group (n = 27) and from 22.4 +/- 9.2 to 10.6 +/- 6.7 in the MMF group (n = 27; p = 0.02). The side effects, time to remission and PDI were similar in both groups.


CONCLUSIONS
After 12 weeks, CsA demonstrated a significantly superior efficacy in psoriasis compared to MMF.
Beissert
Stefan
S
Department of Dermatology, University of Münster, Münster, Germany. beisser@uni-muenster.de
Pauser
Sylvia
S
Sticherling
Michael
M
Frieling
Uta
U
Loske
Klaus-Dieter
KD
Frosch
Peter J
PJ
Haase
Ingo
I
Luger
Thomas A
TA
D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011336:Probability; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid