KMID : 0363220100480030171
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Korean Journal of Dermatology 2010 Volume.48 No. 3 p.171 ~ p.178
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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
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Jeong Taek-Jo
Kim Nack-In Shin Min-Kyung
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Abstract
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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¡Ã25) 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¡¾0.59 mg/L and 1.32¡¾0.86 mg/L, respectively) to oral cyclosporine were significantly higher than the moderate response group (0.51¡¾0.20 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. (Korean J Dermatol 2010; 48(3):171¡178)
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KEYWORD
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Cyclosporine, High sensitivity C-reactive protein, Psoriasis
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