Outcomes of prolonged and low-dose ciclosporin in an Asian population

Abstract

Background

Ciclosporin is used in dermatology for a variety of conditions. Existing guidelines commonly recommend a starting dose of 3–5 mg/kg/day.

Objectives

We sought to assess response in our cohort of patients in whom lower doses of ciclosporin were used, and compare the efficacy and side effect profile with existing literature.

Methods

We retrospectively studied the use of ciclosporin (cyclosporine A) in our dermatological center. Ciclosporin dose trajectories and changes in disease severity were analyzed.

Results

92 patients were studied (64 with eczema, 17 with psoriasis). Mean initiation ciclosporin dose was relatively low at 1.53 mg/kg/day, with an increase to a mean of 2.61 mg/kg/day at 6 months. The median duration of treatment was 180 days (range 3–2160 days, IQR 383). The response was seen as early as 2 weeks, with greatest control of disease at 6 months. 32 patients were on ciclosporin for a period of 1 year or longer, of whom only 1 had a greater than 30% increase in creatinine that crossed the upper limit of normal.

Conclusion

In our population, a lower dose likely resulted in a slower peak to greatest control, but was well tolerated with minimal renal impairment despite a relatively long average period of use.

Keywords:

• Ciclosporin
• cyclosporine A
• atopic dermatitis
• psoriasis
• Asian

Disclosure statement

There are no conflicts of interests or sources of funding to declare for all authors.