V Di Lernia1, L Stingeni2, V Boccaletti3, P G Calzavara Pinton4, C Guarneri5, A Belloni Fortina6, M Panzone7, M Corazza8, I Neri9, S Cambiaghi10, C Lasagni11, E Ficarelli1, P Gisondi12. 1. a Dermatology Unit , Arcispedale Santa Maria Nuova IRCCS , Reggio Emilia , Italy . 2. b Department of Medicine , Section of Clinical, Allergological and Venereological Dermatology, University of Perugia , Perugia , Italy . 3. c Department of Clinical and Experimental Medicine , Section of Dermatology, Parma University Hospital , Parma , Italy . 4. d Department of Dermatology , University of Brescia , Brescia , Italy . 5. e Department of Clinical and Experimental Medicine , Section of Dermatology, University of Messina , Messina , Italy . 6. f Department of Medicine , Pediatric Dermatology Unit, University of Padua , Padua , Italy . 7. g Department of Dermatology , University of Turin , Turin , Italy . 8. h Department of Medical Sciences , Section of Dermatology, University of Ferrara , Ferrara , Italy . 9. i Department of Specialistic , Diagnostic and Experimental Medicine, Dermatology Unit, University of Bologna, S. Orsola-Malpighi Hospital , Bologna , Italy . 10. j UOC Dermatologia Pediatrica, Ospedale Maggiore, Policlinic of Milan , Milan , Italy . 11. k Department of Head and Neck Surgery, Dermatology Unit , University of Modena , Modena , Italy , and. 12. l Department of Medicine , Section of Dermatology and Venereology, University of Verona , Italy.
Abstract
BACKGROUND: Cyclosporine (CysA) is effective for psoriasis in adult patients but little data exist about its efficacy and safety in childhood and adolescence psoriasis. OBJECTIVES: To assess the effectiveness and safety of CysA for childhood and adolescence psoriasis. METHODS: Retrospective analysis of a group of children and adolescents (age < 17 years) with plaque psoriasis treated with CysA at several Italian dermatology clinics. RESULTS: Our study population consisted of 38 patients. The median age at the start of treatment was 12.3 years. Therapy duration varied from one to 36 months. The median maintenance dosage per day was 3.2 mg/kg (range 2-5 mg/kg). Fifteen patients (39,4%) achieved a complete clearance or a good improvement of their psoriasis defined by an improvement from baseline of ≥75% in the psoriasis area and severity index (PASI) at week 16. Eight patients (21.05%) discontinued the treatment due to laboratory anomalies or adverse events. Serious events were not recorded. CONCLUSIONS: In this case series, CysA was effective and well-tolerated treatment in a significant quote of children. CysA, when carefully monitored, may represent a therapeutic alternative to the currently used systemic immunosuppressive agents for severe childhood psoriasis.
BACKGROUND:Cyclosporine (CysA) is effective for psoriasis in adult patients but little data exist about its efficacy and safety in childhood and adolescence psoriasis. OBJECTIVES: To assess the effectiveness and safety of CysA for childhood and adolescence psoriasis. METHODS: Retrospective analysis of a group of children and adolescents (age < 17 years) with plaque psoriasis treated with CysA at several Italian dermatology clinics. RESULTS: Our study population consisted of 38 patients. The median age at the start of treatment was 12.3 years. Therapy duration varied from one to 36 months. The median maintenance dosage per day was 3.2 mg/kg (range 2-5 mg/kg). Fifteen patients (39,4%) achieved a complete clearance or a good improvement of their psoriasis defined by an improvement from baseline of ≥75% in the psoriasis area and severity index (PASI) at week 16. Eight patients (21.05%) discontinued the treatment due to laboratory anomalies or adverse events. Serious events were not recorded. CONCLUSIONS: In this case series, CysA was effective and well-tolerated treatment in a significant quote of children. CysA, when carefully monitored, may represent a therapeutic alternative to the currently used systemic immunosuppressive agents for severe childhood psoriasis.
Authors: Inge M G J Bronckers; Marieke M B Seyger; Dennis P West; Irene Lara-Corrales; Megha Tollefson; Wynnis L Tom; Marcia Hogeling; Leah Belazarian; Claus Zachariae; Emmanuel Mahé; Elaine Siegfried; Sandra Philipp; Zsuzsanna Szalai; Ruth Ann Vleugels; Kristen Holland; Ruth Murphy; Eulalia Baselga; Kelly Cordoro; Jo Lambert; Alex Alexopoulos; Ulrich Mrowietz; Wietske Kievit; Amy S Paller Journal: JAMA Dermatol Date: 2017-11-01 Impact factor: 10.282