건선 환자에서 경구 Cyclosporine 치료 후 재발인자에 대한 연구

Abstract

Background: Cyclosporine, which is one of the effective systemic treatments for psoriasis, has a rapid therapeutic effect. However, despite the efficacy of cyclosporine, the recurrence of psoriasis may still occur if treatment with this drug is discontinued. Several studies on the efficacy and safety of cyclosporine for psoriasis have already been conducted. However, studies on the factors causing psoriasis recurrence after cyclosporine treatment are rare. Objective: The aim of this study was to identify the factors that cause recurrence of psoriasis in patients treated with cyclosporine. Methods: We performed a retrospective study of the medical records obtained between January 2007 and March 2014 of 174 patients diagnosed with psoriasis and followed up for at least 6 months after treatment. We analyzed the differences in the demographic characteristics, body surface area, psoriasis area and severity index (PASI) score, psoriasis type, accompanying psoriatic nail, involvement of exposed areas, and several treatment-related factors (starting dose, last dose, maximal dose, cumulative dose, mean daily dose, and treatment duration) between the group that experienced a recurrence and the group that did not. Additionally, we analyzed the effects of these factors on the recurrence and the time to recurrence. Results: Of the 174 patients, 57 (32.8%) reported a recurrence of the disease. There were statistically significant differences between the two groups in terms of their PASI score (p=0.031) and mean daily dose (p=0.014). In the multiple logistic regression analysis, the PASI score (p-0.017, odds ratio-1.057) and treatment duration (p-0.035, odds ratio=0.984) showed a significant relation with relapse. Conclusion: This study suggests that long-term treatment with cyclosporine is necessary for high-severity psoriasis in patients to prevent recurrence. However, as this study is retrospective, further prospective and large-scale studies are necessary to confirm this fact.