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건선 환자에서 Cyclosporine 치료 효과와 관련된 인자에 대한 후향적 연구
최연구 ( Yeon Gu Choi ),이현주 ( Heun Joo Lee ),최영준 ( Young Jun Choi ),김원석 ( Won-serk Kim ),이가영 ( Ga-young Lee ) 대한피부과학회 2021 大韓皮膚科學會誌 Vol.59 No.4
Background: Cyclosporine is an effective drug for the treatment of psoriasis. Nonetheless, little is known about the factors associated with its effectiveness. Objective: This study aimed to analyze the factors affecting the treatment efficacy of cyclosporine in patients with psoriasis. Methods: ‘Good treatment response’ and ‘treatment failure’ were each defined as achievement of 75% improvement in the psoriasis area and severity index and failure to achieve 50% improvement in the psoriasis area and severity index, respectively. The factors affecting good treatment response were investigated by comparing the group that achieved psoriasis area and severity index 75 to the not achieved group. Similarly, we also analyzed the factors affecting treatment failure and the time required to achieve psoriasis area and severity index 75. Results: In total, 78 patients (63 males and 15 females) were analyzed. Age of onset, body surface area, accompanying hypertension, accompanying psoriatic arthritis, induction phase mean dose, and cumulative dose showed a relationship with good treatment response. Body surface area, initial dose, and accompanying hypertension were correlated with treatment failure. The mean time taken to achieve psoriasis area and severity index 75 was 6.70±3.17 weeks and it did not correlate with any factor. Conclusion: In patients with psoriasis vulgaris, maintaining an adequate mean dose in the induction phase may be necessary for successful treatment with cyclosporine, especially in the patients with early-onset psoriasis, severe psoriasis, or accompanying psoriatic arthritis. In addition, a sufficiently high start dose may be needed to prevent treatment failure, particularly in patients with severe psoriasis vulgaris. (Korean J Dermatol 2021;59(4):266∼276)