Rania Abdel Hay
Accepted Abstracts: J Vaccines Vaccin
Background: Treatment of resistant psoriasis may be difficult and immunotherapy was first reported in the treatment of psoriasis in the 1970's, using live measles vaccine with a high cure rate. Objective: To evaluate the efficacy and safety of live attenuated varicella vaccine as an adjuvant immunotherapeutic modality in treatment of severe resistant psoriasis. Methods: This randomized, placebo controlled, double blinded study included 35 patients with severe resistant psoriasis. Patients were randomly divided into 2 groups; group A (18 patients) and group B (17 patients) who all received cyclosporine at a daily dose of 2.5 mg/kg/day. In addition, group A received 4 doses of live attenuated varicella vaccine once/3 weeks, simultaneously group B received 4 doses of subcutaneous saline in the same pattern as group A. Clinical assessment was based on the psoriasis area and severity index score calculation at each visit. Final patient's response (week 12) was rated according to the physician global assessment. Results: Group A showed significantly higher % of improvement in their PASI score (mean, 95% CI 81.83, 69.05-94.60) than group B (mean, 95% CI 50.12, 34.58-65.66) (P=0.002). Group A achieved a more significant improvement in their score evaluations than group B. 83.3% (15/18) of group A achieved a meaningful improvement (≥50% improvement) versus 47.1% (8/17) of group B (P=0.024). Adverse events were minimal and no drug discontinuation was needed. Conclusion: Taking into consideration some precautions, combined live attenuated varicella vaccine and relatively low dose cyclosporine demonstrated positive responses, and the treatment was well tolerated.
Rania Abdel Hay has completed his M.B.B.Ch at the age of 24 years from Cairo University and she is conducting her postgraduate studies as a student at Faculty of Medicine, Cairo University, Egypt. She has published more than 25 papers in reputed journals and has been serving as an associated editorial board member of repute.