title: Etanercept reduces symptoms and severity of psoriasis after cessation of cyclosporine therapy: results of the SCORE study.
abstract: Cyclosporine is an established therapy for psoriasis that provides rapid relief of symptoms but has long-term toxic side effects. The objective of this study was to demonstrate the efficacy of etanercept as replacement therapy for cyclosporine in patients with moderate-to-severe plaque psoriasis. Patients with plaque psoriasis were given cyclosporine 5 mg/kg/day until achievement of PASI50 at which point cyclosporine was tapered to 0 over 6 weeks. At week 6, patients were randomised (1:1) to receive etanercept (50 mg/week) or placebo for an additional 24 weeks. Patients in the etanercept group (n = 58) experienced a reduction of -1.1 in mean PASI score (p = 0.233 vs. cyclosporine) at week 30; patients in the placebo group (n = 62) had mean PASI increase of 3.7 (p < 0.001 vs. cyclosporine). The incidence of patients reporting any adverse events was not significant between groups (77% etanercept, 74% placebo; p = 0.675). Etanercept demonstrated higher efficacy and good tolerability as replacement therapy for cyclosporine in plaque psoriasis.
authors.affiliation: Department of Dermatology, AOU Policlinico - Vittorio Emanuele, Catania, Italy. cldermct@nti.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Micali
authors.forename: Dagmar
authors.initials: D
authors.lastname: Wilsmann-Theis
authors.forename: Lotus
authors.initials: L
authors.lastname: Mallbris
authors.forename: Gaia
authors.initials: G
authors.lastname: Gallo
authors.forename: Valentina
authors.initials: V
authors.lastname: Marino
authors.forename: Yves
authors.initials: Y
authors.lastname: Brault
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Germain
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D057915:Drug Substitution; D000068800:Etanercept; D005060:Europe; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D016572:Cyclosporine; D000068800:Etanercept