COMPARISON OF 2 THERAPEUTIC REGIMENS, CONTINUOUS MONOTHERAPY AND INTERMITTENT THERAPY, FOR LONG-TERM MAINTENANCE OF REMISSION OF PSORIASIS WITH CYCLOSPORINE-A

Long term therapy with cyclosporin A (CyA) in patients with psoriasis was undertaken in a multicenter study in Japan. Two protocols were ado pted: monotherapy with continuous administration of low doses of CyA f or the maintenance of remission, and intermittent therapy with topical application of corticosteroid during remission. The patients enrolled in the study were randomly divided into the two groups by the envelop e method. The patients, observed for 9-12 months, were analyzed for cl inical efficacy and adverse effects. Although the maintenance doses of CyA, PASI scores, and trough levels throughout the study did not diff er significantly between the two groups, the relapse rate was signific antly higher in the intermittent therapy group. Low PASI scores were m aintained with 0.5-2.5 mg/kg/day of CyA in the continuous monotherapy group. Stable PASI scores were maintained with low doses of CyA for 2 months after remission. Low PASI scores were also maintained with topi cal application alone of corticosteroid without CyA for 2.5-3.5 months during remission in the intermittent therapy group. The major side ef fects observed during the study were hypertension and an increase in s erum BUN levels. There was no statistical significance in frequency of side effects or abnormal laboratory data in the two groups. These res ults indicated that monotherapy with continuous administration of a lo w dose of CyA was more effective in suppressing relapse after remissio n than intermittent therapy, and that the former did not cause any mor e adverse effects than the latter during 9-12 months of CyA therapy.