Short-term, Low Dose Oral Cyclosporine Treatment in Patients with Psoriasis: An Association between Response to Cyclosporine Therapy and Systemic Inflammation Using High Sensitivity C-reactive Protein.
- Author:
Taek Jo JEONG
1
;
Min Kyung SHIN
;
Nack In KIM
Author Information
1. Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea. nikim@khmc.or.kr
- Publication Type:Original Article
- Keywords:
Cyclosporine;
High sensitivity C-reactive protein;
Psoriasis
- MeSH:
Arthritis, Psoriatic;
C-Reactive Protein;
Cyclosporine;
Cytokines;
Humans;
Immunoassay;
Inflammation;
Psoriasis;
T-Lymphocytes
- From:Korean Journal of Dermatology
2010;48(3):171-178
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Cyclosporine is an immunosuppressant that acts on T-cells and cytokines. Although the efficacy of systemic cyclosporine in the treatment of psoriasis has been established, the relationship between response to cyclosporine and systemic inflammation using the high sensitivity C-reactive protein (hs-CRP) immunoassay is still unclear. OBJECTIVE: The aim of this study is to investigate whether systemic inflammation with clinical and laboratory findings indicate a response after 8 weeks of oral 3 mg/kg cyclosporine therapy in patients with psoriasis. METHODS: Thirty-five patients with psoriasis were treated with oral cyclosporine for 8 weeks. The clinical response to oral cyclosporine was determined using the PASI score. The correlation between hs-CRP and the treatment response to cyclosporine was analyzed. Also, descriptive characteristics of psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI (BMI> or =25) were investigated. RESULTS: Hs-CRP levels and PASI scores were significantly reduced after 8 weeks of oral cyclosporine treatment. Eight patients showed excellent response, fifteen a good response, and twelve a moderate response. The baseline hs-CRP levels in excellent and good response groups (1.35+/-0.59 mg/L and 1.32+/-0.86 mg/L, respectively) to oral cyclosporine were significantly higher than the moderate response group (0.51+/-0.20 mg/L, p=0.004). Psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI demonstrated higher levels of baseline hs-CRP. Patients with psoriatic arthritis and metabolic syndrome showed greater response to cyclosporine treatment. CONCLUSION: Patients with greater inflammatory burden, as demonstrated by elevated baseline hs-CRP, have better treatment responses to cyclosporine compared to patients with lesser inflammation.
