Cyclosporine in clinical practice: a retrospective study comparing fixed dose and body weight-based dose regimens in psoriatic patients

BACKGROUND: In the treatment of various diseases, such as diabetes and arterial hypertension, fixed dose therapies have been reported to offer a method to simplify complex treatment regimens. There are numerous clinical trials proving the efficacy of cyclosporine in psoriasis in inducing remission and maintaining results, although there are few studies about the treatment optimization of cyclosporine. METHODS: We performed a 15-year retrospective observational study comparing two groups of psoriatic patients matched for age and sex. We assessed the clinical response, the safety and the compliance who took fixed dose of 200 mg cyclosporine (range 2.2-3.3 mg/kg) compared with a group of patients who took body weight-based dosage. Student's t-test was used to assess the difference in terms of PASI 75 achievement, patient-reported compliance on a five-point scale, DLQI questionnaire, laboratory values and blood pressure. RESULTS: PASI 75 achievement was not statistically different between the two groups. Compliance was good in both groups, and DLQI was also comparable. Laboratory values and blood pressure were not significantly different. CONCLUSIONS: Our study showed no statistically significant difference between the two groups in PASI reduction and PASI 75 achievement, even though the fixed dose was often lower (range 2.2-3.3 mg/kg) than the dosage administered depending on weight. Fixed dose cyclosporine is simple and practical to use in specific clinical settings, in particular when the patient's weight ranges from 60 to 90 kg. This approach can result in improved clinical outcomes and a better quality of life for psoriatic patients.