BLOOD-CONCENTRATIONS AND CLINICAL EFFECT OF CYCLOSPORINE IN PSORIASIS

After approval by the Local Ethical Committee, 60 psoriatic patients, who participated in a previous pharmacokinetic study on cyclosporin A (CsA), gave their informed consent to continue to be studied during th e maintenance treatment and at withdrawal. Peak concentration (C-max), area under the concentration-time curve (AUC), bioavailability, elimi nation half-life, distribution volume, and body clearance were determi ned at monthly check-ups, along with blood pressure, psoriasis area, s everity index (PASI), and creatinine serum levels. No modifications ov er time of treatment were observed on kinetic parameters. At the dose of 5 mg/kg in two daily administrations, a complete remission of the d isease was observed after 1 month's treatment. At withdrawal, a worsen ing of PASI appeared when CsA daily dose reached 2 mg/kg b.w., the mea n trough levels or AUC values being, respectively, 100 and 2,200 ng/ml . hr. There was a trend for patients with hypertension and nephrotoxi city at the end of the maintenance treatment to have higher trough, C- max, and AUC values. Furthermore, blood pressure and serum creatinine tended to correlate better with AUC and C-max, than with trough levels .