Korean J Dermatol.  2021 May;59(4):266-276.

A Retrospective Analysis of the Factors Affecting the Treatment Outcomes of Cyclosporine in Patients with Psoriasis

• Choi YG
• Lee HJ
• Choi YJ
• Kim WS
• Lee GY

Abstract

Background
Cyclosporine is an effective drug for the treatment of psoriasis. Nonetheless, little is known about the factors associated with its effectiveness.
Objective
This study aimed to analyze the factors affecting the treatment efficacy of cyclosporine in patients with psoriasis.
Methods
‘Good treatment response’ and ‘treatment failure’ were each defined as achievement of 75% improvement in the psoriasis area and severity index and failure to achieve 50% improvement in the psoriasis area and severity index, respectively. The factors affecting good treatment response were investigated by comparing the group that achieved psoriasis area and severity index 75 to the not achieved group. Similarly, we also analyzed the factors affecting treatment failure and the time required to achieve psoriasis area and severity index 75.
Results
In total, 78 patients (63 males and 15 females) were analyzed. Age of onset, body surface area, accompanying hypertension, accompanying psoriatic arthritis, induction phase mean dose, and cumulative dose showed a relationship with good treatment response. Body surface area, initial dose, and accompanying hypertension were correlated with treatment failure. The mean time taken to achieve psoriasis area and severity index 75 was 6.70±3.17 weeks and it did not correlate with any factor.
Conclusion
In patients with psoriasis vulgaris, maintaining an adequate mean dose in the induction phase may be necessary for successful treatment with cyclosporine, especially in the patients with early-onset psoriasis, severe psoriasis, or accompanying psoriatic arthritis. In addition, a sufficiently high start dose may be needed to prevent treatment failure, particularly in patients with severe psoriasis vulgaris.

Keyword

Cyclosporine; Psoriasis; Treatment outcome