Uses and safety profile of ciclosporin in ophthalmology

Kashani, Shahram; Mearza, Ali

doi:10.1517/14740338.7.1.79

Cited by 31 publications

(10 citation statements)

References 84 publications

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“…This prolonged residence time and improved ocular absorption of CsA from the cationic emulsions did not result in a greater CsA systemic exposure relative to the anionic emulsion. Blood samples were collected at 20 and 40 minutes and 1,2,4,8,12,24,48, and 72 hours after dosing and their CsA content was assayed. Neither Restasis 0.05% CsA nor NOVA22007 0.1% CsA or NOVA22007 0.05% CsA was associated with systemic CsA exposure.…”

Section: Discussionmentioning

confidence: 99%

Distribution of Cyclosporine A in Ocular Tissues After Topical Administration of Cyclosporine A Cationic Emulsions to Pigmented Rabbits

Daull

Lallemand

Philips

et al. 2013

Cornea

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Section: Discussionmentioning

confidence: 99%

Distribution of Cyclosporine A in Ocular Tissues After Topical Administration of Cyclosporine A Cationic Emulsions to Pigmented Rabbits

Daull

Lallemand

Philips

et al. 2013

Cornea

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“…One of the impediments to the wider use cyclosporine as an immunosuppressive agent is the view that cyclosporine has a high rate of side effects 1, 8, 36. Renal toxicity was reported in 1986, manifested as interstitial fibrosis and tubular atrophy 9.…”

Section: Discussionmentioning

confidence: 99%

Cyclosporine for Ocular Inflammatory Diseases

et al. 2010

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Purpose-To evaluate the clinical outcomes of cyclosporine treatment for non-infectious ocular inflammation Design-Retrospective cohort studyParticipants-Three hundred seventy-three patients with non-infectious ocular inflammation managed at four tertiary ocular inflammation clinics in the United States observed to use cyclosporine as a single non-corticosteroid immunosuppressive agent to their treatment regimen, between 1979-2007 inclusive. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods-Participants Precis:Within one year of cyclosporine therapy, about half of ocular inflammation patients achieved stable, complete inflammatory control, a minority achieved corticosteroid-sparing goals, and <10% successfully discontinued corticosteroids. Toxicity was frequent after 55 years of age. NIH Public Access Author ManuscriptOphthalmology. Author manuscript; available in PMC 2011 March 1. Published in final edited form as:Ophthalmology. and main outcome measures were obtained for every eye of every patient at every visit via medical record review by trained expert reviewers. Main Outcome Measures: Control of inflammation, sustained control after reducing corticosteroid dosages, and discontinuation of therapy because of toxicity.Results-Of the 373 patients (681 eyes) initiating cyclosporine monotherapy, 33.4% by six months and 51.9% by one year gained sustained, complete control of inflammation over at least two visits spanning at least 28 days. Approximately 25% more improved to a level of slight inflammatory activity by each of these time points. Corticosteroid-sparing success (completely controlled inflammation for at least 28 days with prednisone 10 mg/day or less) was achieved by 22.1% by six months and 36.1% within one year. Toxicity led to discontinuation of therapy within one year by 10.7% of the population. Patients over 55 years of age were over 3-fold more likely to discontinue therapy because of toxicity than patients ages 18-39 years. Doses of 151-250 mg/day tended to be more successful than lower doses, and were not associated with a higher discontinuation for toxicity rate; higher doses did not appear to offer a therapeutic advantage.Conclusion-Cyclosporine, with corticosteroid therapy as indicated, was modestly effective for controlling ocular inflammation. Our data support a preference for cyclosporine adult dosing between 151-250 mg/day. While cyclosporine was tolerated by the majority of patients, toxicity was much more frequent with increasing age; alternative agents may be preferred for patients over 55 years of age.Cyclosporine (Cyclosporine A) ...

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“…It also inhibits apoptosis, eosinophil and mast-cell activation, and the release of IL-2, IL-1β, IL-5 and histamine, which are thought to be important mediators of allergic inflammation 19. Topical CsA has been used in the management of several inflammatory ocular surface disorders 20. Double-masked placebo-controlled studies performed in Europe and Asia report a beneficial effect of topical CsA 2% in the treatment of VKC with an aggregate reduction in scores for symptoms and signs ranging from 45 to 55% after 2 weeks 9 21.…”

Section: Discussionmentioning

confidence: 99%