Long-term use of cyclosporine in dermatology

Long‐Term Continuous versus Intermittent Cyclosporin: Therapy for Psoriasis

“…A significantly higher frequency of adverse reactions during long‐term CyA therapy was associated with an age ≥50 years, a diastolic blood pressure ≥75 mmHg, and a baseline serum creatinine ≥1.1 mg/dL (10). Therefore, it has been recommended to avoid long‐term use (≥2 years) of CyA in patients with any of these risk factors (10, 11).…”

Adverse effects with long-term cyclosporin for severe psoriasis

“…Patients with psoriasis, have an increased mortality from cirrhosis 18 and those treated with MTX are more likely to develop hepatoxicity than their counterparts with rheumatoid arthritis 19 . Zachariae 20 has suggested that increased levels of endothelins in patients with psoriasis may increase their susceptibility to nephrotoxicity when treated with CSA. In our limited experience of treating seven patients with atopic eczema with CSA we have not found the same degree of nephrotoxicity.…”

Cyclosporin: applications in small animal dermatology

“…24,26 In these studies, as in some others noted previously, the main determinant for dose alterations was clinical improvement. Peak concentrations of CyA may, however, be more indicative of possible nephrotoxicity, 27 and trough concentrations may be useful if there is unexpected failure, relapse of problems or a high risk of an adverse reaction or drug interaction. 28 The primary recommended safety evaluation in humans is currently renal function tests rather than CyA drug concentrations.…”

“…History and physical exam (for tumours, infections, new medications) 25 Blood pressure 2,22,25 Blood tests as above (though not lipids again if normal at the first 4 weekly check) ± GFR assessment or creatinine clearance 2,22 Consider after 2 years: ± Kidney biopsy 27 Long-term maintenance Complete skin examinations to monitor for the development of malignancies 22 Regular dental examinations 22 Annual physical examinations 22 achieved after a mean 1.4 h (SD, 0.3 h). The mean CyA level after 24 h was 34.0 ng/mL by HPLC assay.…”