A Comparison of Mycophenolate Mofetil with Ciclosporine for the Treatment of Chronic Plaque-Type Psoriasis

被引:13
作者
Beissert, Stefan [1 ,5 ]
Pauser, Sylvia [1 ]
Sticherling, Michael [2 ,3 ]
Frieling, Uta [1 ]
Loske, Klaus-Dieter [1 ]
Frosch, Peter J. [4 ]
Haase, Ingo [5 ]
Luger, Thomas A. [1 ]
机构
[1] Univ Munster, Dept Dermatol, DE-48149 Munster, Germany
[2] Univ Leipzig, Dept Dermatol, Leipzig, Germany
[3] Univ Erlangen Nurnberg, Erlangen, Germany
[4] Klinikum Dortmund GmbH, Dortmund, Germany
[5] Univ Cologne, Cologne, Germany
关键词
Psoriasis; clinical study; Immunosuppression; T cells; QUALITY-OF-LIFE; CONSENSUS CONFERENCE; CYCLOSPORINE NEORAL(R); SAFETY; METHOTREXATE; EFFICACY; THERAPY; ACID; MULTICENTER; DISABILITY;
D O I
10.1159/000226134
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Aims: To compare the efficacy of ciclosporine (CsA) versus mycophenolate mofetil (MMF) in psoriasis, a randomized trial was conducted. Methods: A prospective multicenter randomized open-label clinical trial was performed to compare two parallel groups of patients with chronic plaque psoriasis undergoing different treatments. Therefore, a total of 54 patients with psoriasis were randomly assigned to treatment with either CsA (2.5 mg/kg body weight) or MMF (2 g daily) for 12 weeks, and the drug doses were adjusted according to response. The psoriasis area and severity index (PASI) was used to assess the clinical severity of psoriasis. The primary outcome of this trial was the time to disease relapse. Safety, PASI scores and psoriasis disability index (PDI) were assessed as secondary outcome. Results: There was no difference in time to disease relapse between the two groups. After 12 weeks of treatment, the mean PASI score (+/- SD) decreased from 24.6 +/- 11.1 to 6.6 +/- 7.3 in the CsA group (n = 27) and from 22.4 +/- 9.2 to 10.6 +/- 6.7 in the MMF group (n = 27; p = 0.02). The side effects, time to remission and PDI were similar in both groups. Conclusions: After 12 weeks, CsA demonstrated a significantly superior efficacy in psoriasis compared to MMF. Copyright (C) 2009 S. Karger AG, Basel
引用
收藏
页码:126 / 132
页数:7
相关论文
共 33 条
[1]   Adverse gastrointestinal effects of mycophenolate mofetil - Aetiology, incidence and management [J].
Behrend, M .
DRUG SAFETY, 2001, 24 (09) :645-663
[2]  
BerthJones J, 1996, BRIT J DERMATOL, V135, P775
[3]  
BerthJones J, 1997, BRIT J DERMATOL, V136, P527, DOI 10.1046/j.1365-2133.1997.d01-1229.x
[4]   Change of treatment from cyclosporin to mycophenolate mofetil in severe psoriasis [J].
Davison, SC ;
Morris-Jones, R ;
Powles, AV ;
Fry, L .
BRITISH JOURNAL OF DERMATOLOGY, 2000, 143 (02) :405-407
[5]   MYCOPHENOLIC-ACID FOR PSORIASIS - A REVIEW OF PHARMACOLOGY, LONG-TERM EFFICACY, AND SAFETY [J].
EPINETTE, WW ;
PARKER, CM ;
JONES, EL ;
GREIST, MC .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1987, 17 (06) :962-971
[6]   VALIDATION OF SICKNESS IMPACT PROFILE AND PSORIASIS DISABILITY INDEX IN PSORIASIS [J].
FINLAY, AY ;
KHAN, GK ;
LUSCOMBE, DK ;
SALEK, MS .
BRITISH JOURNAL OF DERMATOLOGY, 1990, 123 (06) :751-756
[7]   PSORIASIS - AN INDEX OF DISABILITY [J].
FINLAY, AY ;
KELLY, SE .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 1987, 12 (01) :8-11
[8]   Methotrexate vs. ciclosporin in psoriasis:: effectiveness, quality of life and safety.: A randomized controlled trial [J].
Flytstrom, I. ;
Stenberg, B. ;
Svensson, A. ;
Bergbrant, I-M. .
BRITISH JOURNAL OF DERMATOLOGY, 2008, 158 (01) :116-121
[9]   SEVERE PSORIASIS - ORAL THERAPY WITH A NEW RETINOID [J].
FREDRIKSSON, T ;
PETTERSSON, U .
DERMATOLOGICA, 1978, 157 (04) :238-244
[10]   The risk of mortality in patients with psoriasis - Results from a population-based study [J].
Gelfand, Joel M. ;
Troxel, Andrea B. ;
Lewis, James D. ;
Kurd, Shanu Kohli ;
Shin, Daniel B. ;
Wang, Xingmei ;
Margolis, David J. ;
Strom, Brian L. .
ARCHIVES OF DERMATOLOGY, 2007, 143 (12) :1493-1499