INTERMITTENT CYCLOSPORINE-A TREATMENT OF SEVERE PLAQUE PSORIASIS - LONG-TERM FOLLOW-UP OF 26 PATIENTS

The aim of this study was to evlauate the long-term effects of intermittent Cyclosporin A treatment of severe plaque psoriasis. For this purpose wt considered the clinical records of 26 patients who had been intermittently treated with Cyclosporin A for 2 to 4 gears. All 26 patients had severe plaque-type psoriasis (PASI score >18) that was unresponsive to conventional treatment. The initial Cyclosporin A dosage was 5 mg/kg/day in 8 cases and 3 mg/kg/day in 18 cases. In all patients, Cyclosporin A treatment was prolonged until complete or nearly complete remission of psoriasis (mean 2 months; range 1-4 months). Ah patients subsequently underwent a 2-4 months maintenance treatment with Cyclosporin A dosages that were gradually I educed until tapering off. In order to maintain clinical improvement after Cyclosporin A withdrawal, patients were treated with topical steroids, topical tar, emollients and UVA exposure and/or eliotherapy. Cyclosporin A treatment (2.5-3 mg/kg/day) was reintroduced only when clinical relapses reached a PASI score of 12 or more. D;ration and dosages of Cyclosporin A cycles a;ere always adapted for the purpose of obtaining an improvement acceptable to the patient (PASI <8) rather than total clearance of psoriasis. So far, the 26 patients have undergone 3-5 cycles of therapy with ion: doses of Cyclosporin A. None of these 26 patients interrupted Cyclosporin A treatment because of side effects. In conclusion, in our experience cyclic CyA treatment is effective for the long-term treatment of psoriatic patients.