Cyclosporin A in psoriatic arthritis: an open study

Article Abstract:

Psoriatic arthritis is associated with lesions of the skin and nails that resemble those seen in patients with psoriasis. The drug cyclosporine A has been used successfully for the treatment of psoriatic skin lesions, and improvement has occurred in these patients who also had arthritis. Similar mechanisms are believed to function in the skin and joints in psoriasis and a study was designed to test the effectiveness of cyclosporine A for psoriatic arthritis. There were three phases of the study: the first phase examined the effectiveness of low-dose cyclosporine A, the second determined the minimal effective maintenance dose, and the third evaluated the duration of improvement in skin lesions and arthritis when the drug was discontinued. Eight patients were evaluated after two and three months and seven patients were evaluated after six months of therapy. There was a significant improvement in the arthritis symptoms in all patients studied and a close correlation was seen between improvement in arthritis and skin lesions. After three months of treatment all patients experienced 70 to 82 percent improvement of skin lesions. Further skin improvements were seen throughout the remainder of the study and the skin lesions almost disappeared. Three of the six patients that were also taking nonsteroidal anti-inflammatory drugs for their arthritis were able to discontinue this therapy and one other patient was able to reduce the dose by half. This study clearly demonstrated that cyclosporine A is effective in clearing psoriatic skin lesions in patients with psoriatic arthritis. This drug should be considered a beneficial alternative for patients who have not responded to other forms of treatment. This study also demonstrated the strong correlation between improvements in arthritis and psoriatic skin lesions and suggests that the same mechanisms must be functioning in these different sites. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psoriasis, Psoriatic arthritis

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Assessment of efficacy and acceptability of low dose cyclosporin in patients with rheumatoid arthritis

Article Abstract:

Cyclosporin is an immunosuppressive agent, a drug that decreases the activity of the immune system. Cyclosporin blocks inflammatory processes by preventing the production of factors, such as interleukin 2 and other lymphokines, that activate inflammation. Studies have shown that this drug is effective in treating rheumatoid arthritis, a joint disease characterized by inflammation of the joints, stiffness, swelling, enlargement of the cartilage, and pain. The therapeutic and adverse effects of cyclosporin depend on dosage, which must be monitored very carefully. The effectiveness and side effects of cyclosporin were evaluated over a one-year period in 49 patients with rheumatoid arthritis. During the study, cyclosporin treatment was discontinued in 32 of the 49 patients. Reasons for discontinuation included lack of effectiveness (10 patients), side effects (11 patients), both ineffectiveness and side effects (nine patients), and unrelated events in two patients. The remaining 17 patients showed clinical improvement within four months of starting cyclosporin treatment, and this therapeutic effect persisted throughout the one-year study. The drug caused toxic effects on the kidney in 24 patients, who required continual monitoring and dose adjustment throughout the trial. The findings show that cyclosporin may be useful in treating patients with RA who do not respond to common anti-rheumatic agents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Rheumatoid arthritis, Dosage and administration

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Effects of cyclosporin at various concentrations on dexamethasone intracellular uptake in multidrug resistant cells

Article Abstract:

The drug cyclosporin may overcome the resistance to corticosteroids in some cells. Many cancer cells and other cells produce a protein that pumps drugs out of the cell. The cell thus becomes resistant to the drug. Corticosteroids may be one drug that this protein pumps out of the cell.

Prevention, Drug resistance

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