STELLENWERT IMMUNSUPPRESSIV WIRKENDER PHARMAKA IN DER ANTIPSORIATISCHEN THERAPIE

Besides of some severe cases resistant to other therapeutics, systemically treatment of psoriasis with corticoids has been abandoned because of the high frequency of side effects and rebounds. The use of topical corticoids is only supplementary, short termed and mostly limited to palms, soles and scalp. Methotrexate has been employed with success for psoriasis for more than 30 years. It's use is limited to severe courses of psoriasis pustulosa, erythrodermica, arthropathica with regard to normal liver, bone marrow and kidney functions. During treatment regular liver and laboratory controls are required. The efficacy of oral Cyclosporin A-therapy for plaque-type, pustular and erythrodermic psoriasis is well recognized. Dosages up to 15 mg CyA/kg/day have been administered before, longterm dose-finding studies now indicate effectivity using dosages from 1,25 to 5 mg CyA/kg/day. The potential risk of side effects increases with high treatment regiments. Regular laboratory controls especially with regard to kidney functions are required. Our preliminary results of a 12 months lasting dose-finding study favour a starting dosage of 2,5 mg CyA/kg/day. Further investigations may give more security in handling this potent acting antipsoriatic agent.