Ciclosporin in Localized and Systemic Scleroderma – A Clinical Study

Abstract

Four patients with systemic scleroderma and 1 patient with localized scleroderma were treated with ciclosporin (CS) given in daily doses between 2.2 and 5.6 mg/kg body weight for 3–26 months. Under this medication clinical improvement was observed in 4 patients with partial regression of cutaneous sclerosis and inflammation, healing of fingertip ulcerations or leg ulcers and improvement of articular mobility. However, in 1 patient with rapidly advancing systemic scleroderma a short-term therapy with CS in low doses (2–3 mg/kg body weight) resulted in arterial hypertension and renal dysfunction. Therefore careful selection of patients and close-meshed controls are indicated when CS is considered as anti-inflammatory treatment in scleroderma.

Successful Treatment of Scleroderma with PUVA Therapy

“…Agents which have been used in the treatment of this disorder include corticosteroids, non-steroidal anti-inflammatory drugs, vitamin E, penicillamine, and cyclosporin (1,2). However, there has been no really satisfactory treatment for this disease.…”

Good response of linear scleroderma in a child to ciclosporin

“…Ciclosporin is a fungal metabolite with potent immunosuppressive activity, affecting both humoral and cell‐mediated immunity. It has been shown to be effective in the treatment of SSc 6 as well as disabling morphoea 7 . Several authors felt that the response to ciclosporin in their patients with SSc was more obvious in the sclerosis of the skin than in the systemic involvement 8 .…”

Calcineurin inhibitors in systemic sclerosis – a systematic literature review

“… 24 Finally, 27 review articles were excluded, and the remaining 37 identified primary research articles were included into the analysis. 24 – 60 The 37 articles consisted of 19 case reports, 15 case series, 1 open-label, randomized controlled trial with a no-treatment arm (group I iloprost vs group II iloprost with low-dose CsA), one open-label, prospective study with a historical control group (CSA group vs historical placebo group of the chlorambucil trial), 61 and one retrospective study without control (patients received prednisolone (0.5 mg/kg/d) and tacrolimus; Table 1 ).…”