Elevation of fasting serum lipids in patients treated with low-dose cyclosporine for severe plaque-type psoriasis. An assessment of clinical significance when viewed as a risk factor for cardiovascular disease.

Abstract

Hyperlipidemia has received little attention as a side effect of cyclosporine therapy for severe psoriasis. We report changes in fasting serum lipids in patients treated with low-dose oral cyclosporine for psoriasis and discuss their significance. Twenty-two patients with severe, recalcitrant, plaque-type psoriasis were treated with cyclosporine, 5 mg/kg/day, for 12 to 16 weeks. Fasting serum lipid levels (triglycerides, cholesterol, and high-density lipoproteins) were measured at 2-week intervals. The mean serum triglyceride level increased from 117.8 +/- 11.7 mg/dl before initiation of therapy to 183.9 +/- 31.4 mg/dl after 2 weeks of treatment, without further significant change during the remainder of the study (p less than 0.007). A significant elevation of serum cholesterol from 207.1 +/- 8.1 mg/dl initially to 247.4 +/- 10.2 mg/dl after 2 weeks of treatment occurred (p less than 0.001) and persisted with continued cyclosporine therapy. No consistent alteration in high-density lipoprotein was noted (p less than 0.42). Serum lipids should be closely monitored in psoriasis patients receiving intermediate or long-term therapy with cyclosporine, especially in the presence of elevated baseline values.