Mycophenolic acid in psoriasis

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Abstract
Mycophenolic acid (MPA) shows antitumor activity in certain animal models. It blocks nucleic acid synthesis by interfering with the interconversions of IMP, XMP and GMP, thereby inhibiting growth and/or replication of tumor cells. In vivo activity depends on the presence of .beta.-glucuronidase which is abundant in the cell wall of epithelial tissues. Of 28 patients with psoriasis, 21 were studied in double-blind fashion. A comparison of disease severity in patients before and after receiving MPA vs. patients receiving placebo clearly showed the superiority of drug over placebo. The mean severity score of patients receiving MPA as an initial course of therapy improved by 56% vs. 9% in patients receiving placebo. Patients receiving MPA after an initial course of placebo therapy showed improvement in their mean severity score averaging 86%. Those patients receiving placebo after an initial course of MPA showed worsening of their mean severity score averaging 70%. About 75% of MPA treated patients showed good to excellent responses, and toxicity appeared low. Apparently MPA may be very useful in treating severe psoriasis.