Etanercept Reduces Symptoms and Severity of Psoriasis After Cessation of Cyclosporine Therapy: Results of the SCORE Study

Cyclosporine is an established therapy for psoriasis that provides rapid relief of symptoms but has longterm toxic side effects. The objective of this study was to demonstrate the efficacy of etanercept as replacement therapy for cyclosporine in patients with moderate-tosevere plaque psoriasis. Patients with plaque psoriasis were given cyclosporine 5 mg/kg/day until achievement of PASI 50 at which point cyclosporine was tapered to 0 over 6 weeks. At week 6, patients were randomised (1:1) to receive etanercept (50 mg/week) or placebo for an additional 24 weeks. Patients in the etanercept group (n=58) experienced a reduction of –1.1 in mean PASI score (p=0.233 vs. cyclosporine) at week 30; patients in the placebo group (n=62) had mean PASI increase of 3.7 (p<0.001 vs. cyclosporine). The incidence of patients reporting any adverse events was not significant between groups (77% etanercept, 74% placebo; p=0.675). Etanercept demonstrated higher efficacy and good tolerability as replacement therapy for cyclosporine in plaque psoriasis.