Therapy with cyclosporine in psoriatic arthritis

https://doi.org/10.1016/S0049-0172(97)80035-2Get rights and content

Abstract

Objective:

To evaluate the efficacy and toxicity of cyclosporin A (CsA) in the treatment of patients with psoriatic arthritis (PsA).

Methods:

We reviewed the literature dealing with CsA treatment of PsA.

Results:

In the 1980s, some studies evaluating CsA in severe cases of psoriasisdocumented an improvement in the associated arthritis. Subsequently, open prospective studies included patients with active peripheral arthritis. Using initial CsA doses of 3 to 6 mg/kg/day, improvement in the clinical parameters was noted. A controlled trial showed that CsA and methotrexate (MTX) are equally effective treatment for PsA. CsA and MTX combination was effective in PsA patients resistant to previous second-line therapy. No studies have evaluated the efficacy of CsA on axial disease and on the progression of radiological damage. The most important side effect was nephrotoxicity. However, of 170 CsA-treated patients in 16 studies, only 10 (6%) discontinued the drug because of renal side effects.

Conclusions:

CsA seems to be an effective and safe therapy for PsA. However, controlled studies on large number of patients are necessary.

References (69)

  • GladmanD.D. et al.

    Psoriatic arthritis (PSA): an analysis of 220 patients

    Q J Med

    (1987)
  • GladmanD.D.

    Psoriatic arthritis

  • GladmanD.D. et al.

    Clinical indicators of progression in psoriatic arthritis: multivariate relative risk model

    J Rheumatol

    (1995)
  • GladmanD.D. et al.

    The role of HLA antigens as indicators of disease progression in psoriatic arthritis: multivariate relative risk model

    Arthritis Rheum

    (1995)
  • WillkensR.F. et al.

    Randomized, double-blind, placebo controlled trial of low-dose pulse methotrexate in psoriatic arthritis

    Arthritis Rheum

    (1984)
  • DougadosM. et al.

    Sulphasalazine in spondylarthropathy: a randomized, multicenter, double-blind, placebocontrolled study

    Arthritis Rheum

    (1995)
  • PalitJ. et al.

    A multicentre double-blind comparison of auranofin, intramuscular gold thiomalate and placebo in patients with psoriatic arthritis

    Br J Rheumatol

    (1990)
  • GladmanD.D. et al.

    Chloroquine therapy in psoriatic arthritis

    J Rheumatol

    (1992)
  • KilnkhoffA.V. et al.

    Pilot study of etretinate in psoriatic arthritis

    J Rheumatol

    (1989)
  • GladmanD.D. et al.

    Longitudinal study of clinical and radiological progression in psoriatic arthritis

    J Rheumatol

    (1990)
  • EllisC.N. et al.

    Cyclosporin improves psoriasis in double blind study

    JAMA

    (1986)
  • MullerW. et al.

    Cyclosporin A for psoriasis

    N Engl J Med

    (1979)
  • MeinardiM.M.H.M. et al.

    Generalized pustular psoriasis (von Zumbusch) responding to cyclosporin A

    Br J Dermatol

    (1987)
  • HarperJ.I. et al.

    Cyclosporine for psoriasis: beneficial effect in refractory skin and joint disease

    Transplant Proc

    (1988)
  • GuptaA.K. et al.

    Cyclosporine in the treatment of psoriatic arthritis

    Arch Dermatol

    (1989)
  • SteinssonK. et al.

    Cyclosporin A in psoriatic arthritis: an open study

    Ann Rheum Dis

    (1990)
  • SuranyP. et al.

    Cyclosporin A treatment in rheumatoid arthritis and psoriatic arthritis

    Hungarian Rheumatol

    (1991)
  • SalvaraniC. et al.

    Low-dose cyclosporine A in psoriatic arthritis: relation between soluble interleukin-2 receptors and response to therapy

    J Rheumatol

    (1992)
  • FossaluzzaV. et al.

    Terapia dell'artrite psoriasica con ciclosporina-A: risultati ad un anno

    Reumatismo

    (1991)
  • KokeljF. et al.

    Psoriatic arthritis treated with cyclosporin A

    Allerg Immunol

    (1992)
  • WagnerS.A. et al.

    Therapeutic efficacy of oral low-dose cyclosporin A in severe psoriatic arthritis

    Dermatology

    (1993)
  • CutoloM. et al.

    Meccanismi immunologici nell'artrite psoriasica e nuove prospettive terapeutiche. Risultati della terapia a lungo termine con bassi dosaggi di ciclosporina A

    Il Reumatologo

    (1993)
  • SchopfR.E. et al.

    Cyclosporin-A benefits both skin and joint disease in psoriatic arthritis

    J Invest Dermatol

    (1994)
  • ForreO. et al.

    An open, controlled, randomized comparison of cyclosporin and azathioprine in the treatment of rheumatoid arthritis: a preliminary report

    Arthritis Rheum

    (1987)

    • Cited by (0)

    View full text
    Copyright © 1997 Published by Elsevier Inc.