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Created: 22Oct97
Neoral in the Treatment of Psoriasis: Consensus Treatment Guidelines
Vincent Ho, M.A. Richard Cloutier, David Gratton, Wayne Gulliver, Gilles J. Lauzon, Kim Papp, and Daniel N. Sauder
Background: The efficacy of cyclosporine in the treatment of psoriasis is well-recognized. A new microemulsion formulation of cyclosporine, Neoral, has become available and will replace the original formulation, Sandimmune.
Objectives: In view of the new clinical experience with Neoral and changes in clinical practice, an expert panel was convened to review the treatment guidelines and make new recommendations for its use in the treatment of psoriasis.
Results: Compared with the original formulation, Neoral is more rapidly absorbed and there is less intra and inter-patient variation in bioavailability. In clinical trials, Neoral had a faster onset of action than Sandimmune at equal doses; efficacy and safety profiles were comparable.
Conclusion: Neoral is indicated in patients with severe psoriasis in whom systemic therapy is justified. Careful baseline clinical and laboratory evaluation is mandatory prior to initiation of Neoral therapy. The therapeutic goal is to maintain substantial improvement with the lowest possible dose of cyclosporine. If possible, intermittent therapy is preferable. Guidelines for monitoring and management of adverse effects are presented.
Journal of Cutaneous Medicine and Surgery. Volume 1, Number 4, 1997
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