Doctors who are prescribing these COX-2 inhibitors for psoriatic arthritis are reporting success. People with psoriatic arthritis who are interested in these medications should talk to their doctors. Like the drug cyclosporine, tacrolimus was originally developed to suppress the immune system of organ or bone marrow transplant patients. Unless the immune system is suppressed, it may reject the organ. When applied topically, tacrolimus absorbs into the skin and begins to neutralize immune cells called cytokines.
Cytokines normally play an important role in the immune system by causing inflammation.
In people with psoriasis, however, the immune response is in overdrive, and cytokines play a role in causing psoriasis lesions to appear. Anecdotal reports and small clinical trials in Europe suggest tacrolimus may be effective in treating chronic plaque psoriasis. Results of the treatments were similar when applied topically under occlusion for 2 weeks. No adverse drug effects were seen in any of the patients in the study. However, tacrolimus will be expensive for psoriasis patients, because insurance companies will likely not cover the cost as the drug is not specifically approved for treating psoriasis.