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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2005 October;140(5):575-82
language: English, Italian
Evaluation of the efficacy and tolerability of a new intermittent treatment regimen with cyclosporin A in severe psoriasis
Vena G. A. 1, Cassano N. 1, Galluccio A. 2, Loconsole F. 1, Coviello C. 1, Fai D. 3, Dattola S. 4, Ferrari A. 4, Ligori P. 3, Lopreiato R. 4, Pellè S. 3, Postorino M. F. 4, Ricciuti F. 5, Valenti G. 6, Malvindi C. 3, Lui P. 7
1 Second Unit of Dermatology Department of Internal Medicine Immunology and Infectious Diseases University of Bari, Bari, Italy
2 Division of Dermatology and Phototherapy Ospedale Fatebenefratelli, Benevento, Italy
3 Collegio Salentino di Dermatologia, CSD, Italy
4 Associazione Dermatologi della Magna Grecia, ADMG, Italy
5 Division of Dermatology, Ospedale San Carlo, Potenza, Italy
6 Division of Dermatology Ospedale di Catanzaro, Catanzaro, Italy
7 Dermatology Service, ASL Mantova, Mantova, Italy
Aim. The aim of this study was to evaluate the efficacy and tolerability of a new intermittent treatment regimen with cyclosporin A (CsA) in severe psoriasis.
Methods. Patients with severe chronic plaque psoriasis (PASI≥12) were allocated to 2 different six-month duration treatment regimens consisting of continuous administration of CsA, 4 mg/kg/day (group A) or CsA administered for 4 consecutive days per week (group B). After the baseline, visits were carried out after 2, 4 and 6 months of therapy, assessing PASI and severity of pruritus graded with a five-point scale.
Results. Eligible patients were 203:101 subjects in group A and 102 in group B. Baseline PASI was significantly more severe in group A than group B (30.12±12.74 versus 24.71±11.44, P=0.000), as well as the severity of pruritus (1.92±1.15 versus 1.58±1.04, P=0.057). Instead, at the baseline, concomitant controlled hypertension was more frequent in group B (47 subjects) as compared with group A (25 patients). Both treatment regimens caused a significant improvement of PASI and pruritus at each visit (P<0.05). Frequency of adverse events was 31% in group A and 12% in group B; they caused premature treatment discontinuation in only 6 patients (4 in group A and 2 in group B). Interestingly, abnormal pressure values were more frequently detected in group A that in group B (21% versus 7%).
Conclusion. Our preliminary data suggest that this new schedule of intermittent treatment with CsA is effective in severe psoriasis and appears to show a better tolerability profile than continuous treatment.