Cyclosporin in psoriasis: continuous monotherapy versus intermittent long-term therapy

Using two methods (continuous monotherapy and intermittent therapy) for the treatment of psoriasis with cyclosporine, we observed the clinical efficac y and adverse reactions of each treatment method for more than 36 months to evaluate the clinical usefulness of both methods. Thirty-seven cases were analyzed and the following results were obtained: 1) The PASI score evaluat ed at each visit was maintained between 5 and 10 by both treatment methods and the improvement rate was more than 70%, while there was no difference i n the daily dose between the two treatment methods; 2) The period required to achieve remission tended to be prolonged by intermittent therapy, while no change was observed with continuous monotherapy; 3) The period up to rel apse tended to become shorter with both treatment methods but this tendency was more marked with intermittent therapy; 4) E-PAP(evaluation for prognos is with averaged PASI) was lower in the continuous monotherapy group and th e patients were more satisfied; 5) The incidence of adverse reactions was s imilar to that reported in previous studies, with no difference between the two treatment methods in this regard; 6) A significant increase in BUN lev els was observed in elderly patients; 7) There were only three cases in whi ch the drug was discontinued due to exacerbation and adverse reactions. Bas ed on the above findings, continuous monotherapy seems to be of greater cli nical usefulness than intermittent therapy.