In a well-written, scholarly, evidenced-based analysis, Gelfand and Abuabara1 identified 3 major limitations of a trial of weight loss and low-dose cyclosporine to treat obese patients with psoriasis.2 The limitations included potential bias in assessment of disease severity, potential effect of dropouts, and failure to control for the direct effect of diet alone on cyclosporine pharmacodynamics. While these factors could have affected the results, another factor, adherence to treatment, should be considered.
Rajpara AN, Feldman SR. Adherence to Treatment: Still the Forgotten Variable. Arch Dermatol. 2010;146(10):1183-1184. doi:10.1001/archdermatol.2010.269