Objectives 20% of the patients with psoriatic arthritis (PA) may develop a very severe form of arthritis. When the skin disease is extensive, it makes sense to use medications which are thought to be effective for both, the skin and joint disease. The efficacy of the cyclosporin A (CyA) on the skin lesiones in psoriasis has been shown in several controlled studies. A few authors demonstrated the anti-inflammatory efficacy of the drug in the PA. The most important action of CyA is the inhibition of production of cytokines by T-cells. We have evaluated efficacy and tolerability of CyA in PA patients.56 patients with average age of 47 (range 33–71), 21 female and 35 male have been treated with 3 mg/kg per day for 6 months. 19 patients received low doses of corticosteroids, nobody received other DMARD during the treatment.
Methods Several clinical and laboratory parameters for the assessment of joint status at the start and at the end of the study were employed: Ritchie index, duration in minutes of morning stiffness with a semi-quantitive evaluation the presence or absence of the onychopathy. We also performed at monthly interval the systolic blood pressure values and the laboratory parameters: erythrocyte sedimentation rate, CRP, serum creatinine and blood urea and liver enzymes. We measured a concentration of the drug in serum with Fluorescence polarisation immuno assay (ABOTT) method at the beginning and at the end of the study.
Results The results are shown in the following Table 1. (statistical-analysis t-student-test)
Conclusion Six of our patients drop out because of high blood pressure, all other patients finished the study. Our results show a good tolerability and efficacy on the joint pain, on the morning stiffness and on the skin lesions.