MedWire News: Rifampicin is an inexpensive alternative therapeutic option for patients with guttate psoriasis, say researchers.

Rifampicin is in widespread clinical use, mainly in patients with tuberculosis. It is an antibiotic, but accumulating evidence supports additional immunosuppressive properties.

N Tsankov and I Grozdev (Medical Faculty, Sofia, Bulgaria) administered rifampicin 600 mg to 52 patients with guttate psoriasis.

During 60 days of treatment, the average Psoriasis Area and Severity Index (PASI) score fell from 7.75 to 2.57 in patients who had concomitant streptococcal infection.

Similar improvement, from an average PASI score of 9.13 to 2.69, occurred among patients without concomitant infection, indicating that the benefits of the drug did not derive from its antibiotic properties.

“Our point of view is that rifampicin acts as a moderate immunosuppressor,” the researchers write in the Journal of the European Academy of Dermatology and Venereology.

“We believe that our results are promising in the continuous search for alternative and unusual therapeutic modalities with good efficacy and tolerability, well known and reported side-effects, and at the same time providing psoriatic patients with a certain period of remission and improvement in their quality of life,” say Tsankov and Grozdev.

“Due to its immunosuppressive effects, we state that rifampicin could be a cheap therapeutic modality for guttate psoriasis.”

However, they caution that use of the antibiotic in psoriasis patients could also encourage antibiotic resistance.

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