Eight patients whose severe psoriasis was treated with long-term cyclosporin (range 2-11 years; mean 7.6 years) were changed to mycophenolate mofetil (MMF), because of nephrotoxicity in seven and hypertension and lack of efficacy in one. Combined mycophenolate mofetil and cyclosporin therapy for severe recalcitrant psoriasis. Chronic urticaria (CU) or chronic spontaneous urticaria is defined by the presence of urticaria (hives) on most days of the week, for a duration of longer than six weeks. We have categorized the calcineurin inhibitors, sirolimus, and mycophenolate mofetil in this way. We choose sulfasalazine instead of dapsone for patients with underlying anemia, and sometimes initiate therapy with the combination of sulfasalazine and hydroxychloroquine, as described above. These patients had relatively recalcitrant disease. A randomized, blinded, parallel-group, pilot trial of mycophenolate mofetil (CellCept) compared with interferon beta-1a (Avonex) in patients with relapsing-remitting multiple sclerosis Therapeutic Advances in Neurological Disorders January 2010 3: 15-28, doi:10.
Therefore, mycophenolate mofetil therapy was started. The combination therapy increases the efficacy and decreases the dose of individual drug, thereby decreasing the side effects. After an initial observation of the improvement of psoriasis in one heart and three liver transplant recipients on tacrolimus, the drug was tested in severe recalcitrant psoriasis patients with good response. Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid. Methotrexate, cyclosporine and retinoids are the most commonly used conventional systemic drugs. Systemic therapies are generally used in patients with severe plaque type disease ( 10 body surface area BSA or 10 psoriasis area and severity index PASI ), generalized pustular psoriasis, psoriatic erythroderma, severe psoriatic arthritis (PsA) and in those who are refractory to topical therapy and phototherapy. Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid. Long-term control of recalcitrant psoriasis with combination infliximab and methotrexate.
Introduced in the 1970s as a treatment for psoriasis, mycophenolic acid has since been reformulated as mycophenolate mofetil (MMF). Compared to other immunosuppressants, such as methotrexate, azathioprine and cyclosporine, the lack of hepatonephrotoxicity with MMF offers an important therapeutic advantage. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J.N. Combined mycophenolate mofetil and cyclosporin therapy for severe recalcitrant psoriasis. Et al, Combination treatment with methotrexate and cyclosporine for severe recalcitrant psoriasis. The most successful approach in these patients was a combination of acitretin with narrowband UVB, which resulted in 72. Topical therapies may also have a role in recalcitrant psoriasis.
Psoriasis is a common chronic skin disease characterized by cutaneous inflammation and epidermal hyperproliferation. UVB may be given alone or in combination with tar or dithranol. Other systemic treatments for psoriasis include methotrexate or cyclosporine. Mycophenolate mofetil is a promising alternative to cyclophosphamide. Thalidomide for Recalcitrant Cutaneous Lupus Erythematosus. Azathioprine has been reported to be successful in treating severe AD in uncontrolled studies, mostly in adults. A 1-year randomized controlled study comparing cyclosporine with combined UVA and UVB phototherapy reported a significant increase in serum creatinine in 6 of patients and the development of mild-to-moderate hypertension in 19 of patients receiving cyclosporine. In my experience, the new oral immunosuppressive medication mycophenolate mofetil (MMF) shows considerable promise.