title: Cyclosporine regimens in plaque psoriasis: an overview with special emphasis on dose, duration, and old and new treatment approaches.
abstract: Cyclosporine A (CsA) is one of the most effective systemic drugs available for the treatment of psoriasis, as evidenced by the results of several randomized studies and by a prolonged experience in dermatological setting. In clinical practice, CsA is usually used for the induction of psoriasis remission at a daily dose included in the range of 2.5-5 mg/kg and with intermittent short-term regimens, lasting on average 3-6 months. The magnitude and rapidity of response are dose dependent, as well as the risk of development of adverse events. Therefore, the dose should be tailored to patient's needs and general characteristics and adjusted during the treatment course according to both the efficacy and tolerability. Some studies support the feasibility of pulse administration of CsA for a few days per week for both the induction and the maintenance of response in psoriasis patients. This paper will review the data on CsA regimens for plaque-type psoriasis and will focus the attention on dose, treatment duration, novel schedules, and role in combination therapies, including the association with biologicals.
authors: Novartis Farma SpA, Origgio, Varese, Italy. delia.colombo@novartis.com
authors: M D
authors: MD
authors: Colombo
authors: N
authors: N
authors: Cassano
authors: G
authors: G
authors: Bellia
authors: G A
authors: GA
authors: Vena
mesh_terms: D016572:Cyclosporine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine
references: Ann Rheum Dis. 2010 May;69(5):934-5
references: 19666936
references: J Am Acad Dermatol. 1992 Oct;27(4):594-8
references: 1401311
references: J Eur Acad Dermatol Venereol. 1998 Nov;11(3):234-9
references: 9883435
references: J Am Acad Dermatol. 1990 Nov;23(5 Pt 1):925-6
references: 2254478
references: Br J Dermatol. 1997 Apr;136(4):531-5
references: 9155953
references: J Dermatolog Treat. 2007;18(5):286-90
references: 17852632
references: Am J Clin Nutr. 2008 Nov;88(5):1242-7
references: 18996858
references: Arch Dermatol. 1995 Jul;131(7):791-5
references: 7611794
references: J Eur Acad Dermatol Venereol. 1998 Sep;11(2):177-9
references: 9784049
references: J Eur Acad Dermatol Venereol. 2011 May;25 Suppl 2:19-27
references: 21388455
references: J Am Acad Dermatol. 1990 Aug;23(2 Pt 1):320-1
references: 2212132
references: J Am Acad Dermatol. 2004 Mar;50(3):416-30
references: 14988684
references: J Eur Acad Dermatol Venereol. 2007 Oct;21(9):1161-9
references: 17894699
references: Pharmacoeconomics. 2001;19(5 Pt 2):599-608
references: 11465304
references: J Dermatol. 2011 May;38(5):465-72
references: 21352289
references: J Am Acad Dermatol. 1995 Sep;33(3):470-5
references: 7657870
references: J Am Acad Dermatol. 1995 Jan;32(1):78-88
references: 7822521
references: Int J Dermatol. 2007 Aug;46(8):880-2
references: 17651179
references: J Rheumatol. 2011 Nov;38(11):2466-74
references: 21885499
references: Am J Clin Dermatol. 2001;2(1):41-7
references: 11702620
references: Br J Dermatol. 2004 May;150 Suppl 67:11-23
references: 15115441
references: N Engl J Med. 2003 Aug 14;349(7):658-65
references: 12917302
references: J Dermatolog Treat. 2014 Feb;25(1):50-3
references: 23469768
references: Clin Exp Dermatol. 2001 Jun;26(4):356-61
references: 11422189
references: J Dermatol. 2007 Jul;34(7):430-4
references: 17584318
references: Br J Dermatol. 2008 Jan;158(1):116-21
references: 17986302
references: Br J Dermatol. 2001 May;144(5):967-72
references: 11359382
references: Eur J Dermatol. 2005 Nov-Dec;15(6):470-3
references: 16280301
references: Pharmacoeconomics. 2012 Nov 1;30(11):1005-13
references: 22994598
references: Br J Dermatol. 1999 Aug;141(2):283-91
references: 10468801
references: Clin Exp Dermatol. 2006 Jul;31(4):520-4
references: 16716153
references: J Am Acad Dermatol. 2009 Sep;61(3):451-85
references: 19493586
references: Clin Dermatol. 2010 Jan-Feb;28(1):88-92
references: 20082957
references: Arthritis Rheum. 1997 Oct;40(10):1843-51
references: 9336420
references: Int J Dermatol. 1997 Dec;36 Suppl 1:25-9
references: 9466218
references: Dermatology. 1998;196(2):231-6
references: 9568413
references: Pharmacotherapy. 2005 Jan;25(1):52-8
references: 15767220
references: Dermatology. 2002;205(4):383-8
references: 12444336
references: Br J Dermatol. 1994 Mar;130(3):366-75
references: 8148280
references: Dermatology. 1993;187 Suppl 1:19-29
references: 8369576
references: Ann Rheum Dis. 2005 Jun;64(6):859-64
references: 15528283
references: Ann Rheum Dis. 2011 Apr;70(4):712-4
references: 20810394
references: Acta Derm Venereol. 1997 Mar;77(2):137-41
references: 9111826
references: Br J Dermatol. 1998 Mar;138(3):443-9
references: 9580797
references: J Am Acad Dermatol. 2001 Nov;45(5):649-61; quiz 662-4
references: 11606913
references: J Am Acad Dermatol. 1994 Jun;30(6):1023-4
references: 8188867
references: N Engl J Med. 1991 Jan 31;324(5):277-84
references: 1986287
references: J Dermatolog Treat. 2012 Aug;23(4):255-60
references: 21756153
references: J Eur Acad Dermatol Venereol. 2007 Oct;21(9):1203-8
references: 17894706
references: J Am Acad Dermatol. 2010 Dec;63(6):949-72; quiz 973-4
references: 21093660
references: J Am Acad Dermatol. 1999 Sep;41(3 Pt 2):S18-21
references: 10459142
references: Br J Dermatol. 1996 Sep;135 Suppl 48:31-4
references: 8881902
references: Int J Immunopathol Pharmacol. 2010 Jan-Mar;23(1):363-7
references: 20378025
references: J Dermatol. 2011 Oct;38(10):966-72
references: 21545506
references: N Engl J Med. 1995 Jul 20;333(3):137-41
references: 7791814
references: Br J Dermatol. 1998 Jul;139(1):88-95
references: 9764154
references: Br J Dermatol. 1990 Jun;122 Suppl 36:33-9
references: 2196082
references: J Am Acad Dermatol. 1999 Sep;41(3 Pt 2):S25-8
references: 10459144
references: Br J Dermatol. 1999 Aug;141(2):279-82
references: 10468800
references: Acta Derm Venereol Suppl (Stockh). 1994;186:116-7
references: 8073808
references: J Am Acad Dermatol. 1995 Oct;33(4):637-45
references: 7545705
references: J Am Acad Dermatol. 2001 Apr;44(4):643-51
references: 11260540
references: J Am Acad Dermatol. 1992 Jan;26(1):86-90
references: 1732342
references: Br J Dermatol. 1993 Jan;128(1):42-4
references: 8427820
references: J Dermatolog Treat. 2011 Oct;22(5):276-84
references: 20666676
references: Dermatology. 1997;194(1):88-90
references: 9031805
references: Acta Derm Venereol. 1999 Jan;79(1):87
references: 10086872
references: J Am Acad Dermatol. 1997 Mar;36(3 Pt 1):423-32
references: 9091474
references: J Am Acad Dermatol. 2010 May;62(5):838-53
references: 19932926
references: J Dermatolog Treat. 2012 Aug;23(4):290-304
references: 21936704
references: Br J Dermatol. 1997 Mar;136(3):470-1
references: 9115943
references: J Dermatol. 2003 Apr;30(4):290-8
references: 12707465
references: Int J Immunopathol Pharmacol. 2010 Oct-Dec;23(4):1143-52
references: 21244763
references: N Engl J Med. 1979 Sep 6;301(10):555
references: 460314
references: J Am Acad Dermatol. 1994 Jul;31(1):68-74
references: 8021375
references: J Investig Dermatol Symp Proc. 2004 Mar;9(2):136-9
references: 15083780
references: J Eur Acad Dermatol Venereol. 2009 Oct;23 Suppl 2:1-70
references: 19712190