Treatment of psoriasis with cyclosporine once daily before breakfast (1st report)

We administered cyclosporine A (NEORAL®) at a daily dose of 2.5 mg/kg before breakfast to seven patients with psoriasis, and measured the drug level at 1 hour after dosing (C1). Relatively rapid improvement of skin manifestations was achieved. Especially in patients with moderate to severe psoriasis and a PASI score of more than twelve points, there was 74.8% improvement of the PASI score at four weeks and 81.6% improvement of the score after eight weeks. As adverse effects, three out of seven patients developed an increase of blood pressure and complained of feeling dull and of flushing. These symptoms were more likely to occur in the patients with relatively high C1 levels (that is more than 1000 ng/ml). In conclusion, administration of NEORAL® once daily before breakfast seems to be a useful method to induce the remission of psoriasis, but further assessment should be done.