Saratov JOURNAL of Medical and Scientific Research

Osina A.V.

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Department of Dermatovenereology and Cosmetology, Medical Resident

Assessment of the efficiency of cyclosporine use in psoriasis

Year: 2017, volume 13 Issue: №3 Pages: 673-678
Heading: Dermatovenerology Article type: Review
Authors: Kruglova L.S., Ponich E.S., Osina A.V., Gryazeva N.V.
Organization: Central State Medical Academy of the ADP of the Russian Federation
Summary:

The article presents a review of randomized studies involving patients with severe psoriasis, which showed that after 10-12 weeks of monotherapy with cyclosporine there was a decline of the Index of prevalence and severity of psoriasis (PASI). After achieving clinical remission must be decided on a gradual reduction of the dose of cyclosporine to the lowest effective dose, or the complete abolition of the medication. Simultaneous use of cyclosporine and UVB at the moment is not widely studied. Combined use of methotrexate and cyclosporine has been used successfully in the treatment of rheumatoid and psoriatic arthritis. The combined intake of cyclosporine and systemic biological agents should be used in exceptional cases of severe forms of psoriasis, not amenable to other treatments, and only for a limited period of time.

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Analysis of the various schemes efficiency of methotrexate use in psoriasis treatment

Summary:

Currently, there has been a steady increase in the incidence of psoriasis, including severe forms. It is extremely important for psoriasis to administrate medicines in time. Methotrexate inhibits the increased proliferation of keratinocytes, inhibits the production of such inflammatory mediators as leukotrienes, TNF-a, collagenase, IL-1, IL-6, but at the same time it increases production of anti-inflammatory IL-10. Objective: to analyze the efficacy of methotrexate in various forms of psoriasis. Material and Methods. Under observation in the period from 2011 to 2016 were 516 patients, including those treated with methotrexate. Methotrexate was assigned according to the scheme: 1st injection 10mg/week, with no adverse effects 20-25 mg/week. All patients received folic acid at a dose of 20-40 mg/day for 5 days starting 3 days after the injection of methotrexate. Evaluation of efficiency was carried out using indices of dermatological status and quality of life. Results. Achievement of clinical remission was observed in 257 (49.7%) in patients; achieving a significant improvement was noted in 32 (6.2%) patients; achieving improvements in 126 (24.4%) patients; no effect 33 (6.4%) patients, and deterioration (further progression of skin lesions) were observed in 68 (13.2%) patients. Conclusion. Methotrexate has a high efficacy in such clinical forms of psoriasis as vulgar (64.9%), inverse (63.9%), exudative (44.7%), and pustular palmar-plantar psoriasis 12.9%.

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