Cyclosporine is highly effective for the treatment of moderate to severe psoriasis that does not respond well to other treatments. It can be effective for all types of psoriasis, including erythrodermic psoriasis, pustular psoriasis, and psoriatic arthritis.
Cyclosporine can provide fairly rapid relief from psoriasis symptoms, providing improvement in symptoms after two weeks of treatment. It is thus a useful option for the treatment of a rapid psoriasis flare. It may also be considered for people who require treatment for a significant life event, such as a wedding.
However, cyclosporine is recommended for short-term use only. Cyclosporine should be stopped after the psoriasis has cleared or nearly cleared. At that time, the dose of cyclosporine should be tapered while a different therapy is initiated, such as acitretin (Soriatane), methotrexate, or a biologic medication.
Cyclosporine belongs to the group of medicines known as immunosuppressive agents and was developed to prevent organ rejection in recipients of organ transplants. The medication prevents the activation of the T-cells (a part of the immune system) that are involved in rapid growth of skin cells. Because cyclosporine is an immunosuppressant, people with cancer, active infections or immunodeficiency are not good candidates for treatment with cyclosporine.
Because of possible side effects from prolonged use, particularly kidney damage (nephrotoxicity), cyclosporine should not be used for more than one year. Blood tests are performed to monitor kidney function while on treatment.
The use of cyclosporine for elderly people with psoriasis requires particular attention because of the additional risk of developing side effects.
Cyclosporine should not be used by pregnancy women, or women planning to become pregnant unless absolutely necessary.
Phototherapy is not usually used at the same time that someone is receiving cyclosporine because of the increased risk of developing skin cancer when exposed to UV radiation while taking an immunosuppressant.
Reference: Gerald D. Weinstein and Alice. B. Gottleib, Therapy of Moderate-to-Severe Psoriasis, 2nd Edition (New York: Marcel Dekker, Inc., 2003), p. 132.