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Cyclosporine in Severe Psoriasis

Results of a Meta-Analysis in 579 Patients

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Abstract

Objective

A meta-analysis of 3 major German studies conducted between 1989 and 1994 with cyclosporine in severe psoriasis was performed to allow an integrated evaluation of the efficacy and tolerability of cyclosporine in this indication.

Design and Setting

All 3 studies were prospective, randomized, parallel group studies. The studies were conducted in 61 dermatologic centers in Germany.

Patients and Interventions

The studies involved 597 patients with severe plaque type psoriasis. Treatment consisted of cyclosporine (at a dosage of 1.25, 2.5 or 5 mg/kg/day), etretinate (at a mean daily dose of 0.53 mg/kg/day) or placebo in a total of 756 treatment cycles with a maximum duration of 12 weeks.

Main outcome measures: The main outcome measures were the psoriasis area and severity index (PASI) and

serum creatinine level.

Results

The meta-analysis revealed that cyclosporine given in a dosage of 2.5 and 5 mg/kg/day was significantly superior to etretinate. In addition cyclosporine 1.25 mg/kg/day proved to be significantly more effective than placebo. An increase in serum creatinine level that required intervention occurred in 3.4% of cyclosporine treatment cycles.

Conclusion

Cyclosporine is highly effective and well tolerated in the short term treatment of severe psoriasis.

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Acknowledgements

The authors gratefully acknowledge the cooperation of Helmut Bachmann, who performed the statistical analysis.

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Authors and Affiliations

  1. Department of Pharmacology, University of Regensburg, Regensburg, Germany

    Lothar Faerber

  2. Clinical Research Department, Novartis Pharma GmbH, Roonstrasse 25, 90429, Nuremberg, Germany

    Matthias Braeutigam & Gottfried Weidinger

  3. Department of Dermatology, University of Kiel, Kiel, Germany

    Ulrich Mrowietz & Enno Christophers

  4. Department of Dermatology, University of Cologne, Cologne, Germany

    H. J. Schulze & G. Mahrle

  5. Department of Dermatology, Charité Hospital Berlin, Berlin, Germany

    Hans Meffert

  6. Department of Dermatology, University of Bonn, Bonn, Germany

    Sabine Drechsler

Authors
  1. Lothar Faerber
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  2. Matthias Braeutigam
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  3. Gottfried Weidinger
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  4. Ulrich Mrowietz
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  5. Enno Christophers
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  6. H. J. Schulze
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  7. G. Mahrle
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  8. Hans Meffert
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  9. Sabine Drechsler
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Correspondence to Matthias Braeutigam.

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Faerber, L., Braeutigam, M., Weidinger, G. et al. Cyclosporine in Severe Psoriasis. Am J Clin Dermatol 2, 41–47 (2001). https://doi.org/10.2165/00128071-200102010-00007

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  • DOI: https://doi.org/10.2165/00128071-200102010-00007

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