The use of cyclosporine in dermatology: Part II - 24/04/13

Doi : 10.1016/j.jaad.2010.02.062

Caitriona Ryan, MBBCh, BAO ^a, Karrie T. Amor, MD ^b, Alan Menter, MD ^a,^⁎
^a Department of Dermatology at Baylor University Medical Center, Dallas, Texas
^b Department of Dermatology, University of Texas, Houston, Texas

Correspondence to: Alan Menter, MD, Department of Dermatology, Baylor Research Institute, 3900 Junius St, Ste 145, Dallas, TX 75246.

Abstract

Cyclosporine is highly effective in the treatment of a multitude of dermatoses. Concern over its side effect profile has limited its use in dermatology. Adverse effects are, for the most part, dose dependent and related to duration of therapy. Using the recommended monitoring protocols results in a significant decrease in the incidence of cyclosporine-related toxicities. This article provides a comprehensive review of the pharmacokinetics of cyclosporine, potential drug interactions, adverse effects, and recommendations for monitoring in patients treated with cyclosporine. The use of cyclosporine in pregnancy and in the pediatric population is also addressed.

Learning objectives

After completing this learning activity, participants should be familiar with the monitoring guidelines of cyclosporine, its contraindications, its possible drug interactions, its adverse effect profile, and its use in pregnancy and the childhood and adolescent populations.

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Key words : atopic dermatitis, calcineurin inhibitors, cyclosporine, drug interactions, pharmacokinetics, psoriasis

Plan

Bruce H. Thiers, MD, Editor, has disclosed the following financial relationships: Elsevier- Other/Honoraria, Galderma- Other/Honoraria, Graceways Pharmaceuticals- Consultant/Honoraria. Dirk M. Elston, MD, Deputy Editor, has disclosed the following financial relationships: Intendis- Investigator/No Compensation. Robert T. Brodell, MD, JAAD CME Planner, has disclosed the following financial relationships: 3M/Graceway Pharmaceuticals- Speaker/Honoraria, Allergan- Speaker/Honoraria, Dermik/BenzaClin- Speaker/Honoraria, Dow Pharmaceutical Sciences- Consultant/Honoraria, Galderma Laboratories, LP- Speaker/Honoraria, GlaxoSmithKline- Speaker/Honoraria, Graceway Pharmaceuticals, LLC- Speaker/Honoraria, Medicis- Advisory Board/Honoraria, Novaritis Pharmaceuticals- Speaker/Honoraria, Promius- Advisory Board/Honoraria, Sanofi-Aventis- Speaker/Honoraria. Joseph C. English III, MD, JAAD CME Planner, has disclosed the following financial relationships: Centocor- Investigator/No compensation. James R. Treat, MD, JAAD CME Planner, has disclosed the following financial relationships: Pierre Fabre-Investigator/Grants. Hensin Tsao, MD, JAAD CME Planner, has disclosed the following financial relationships: Genentech- Consultant/Honoraria, Quest Diagnostics- Consultant/Honoraria, SciBASE-Consultant/Honoraria. Matthew Zirwas, MD, JAAD CME Planner, has disclosed the following financial relationships: Astellas Pharmaceuticals- Speaker/Honoraria, Coria Laboratories- Speaker/Honoraria, Consultant/Honoraria, Onset Therapeutics-Consultant/Honoraria. Caitrona Ryan, MBBCh, BAO, Author, has disclosed the following financial relationships: Abbott-Other/Grant, Galderma- Advisory Board/Honoraria. Alan Menter, MD, Author, has disclosed the following financial relationships: Abbott- Advisory Board/Grant, Consultant/Honoraria, Investigator/Honoraria, Speaker/Honoraria, Amgen-Speaker/Honoraria, Advisory Board/Grant, Astellas- Consultant/Grant, Advisory Board/Honoraria, Celgene-Investigator/Grant, Centocor- Advisory Board/Honoraria, Consultant/Grant, Eli Lilly-Investigator/Grant, Galderma- Advisory Board/Honoraria, Speaker/Honoraria, Genentech- Advisory Board/Grant, Novartis- Investigator/Grant, Novo Nordisk- Investigator/Grant, Pfizer, Investigator/Grant, Promius-Investigator/Grant, Stiefel- Investigator/Grant, Syntrix-Investigator/Grant, Warner Chilcott-Advisory Board/Honoraria, Wyeth-Advisory Board/Honoraria, Speaker/Honoraria, Investigator/Grant. All other authors, editors, planners, peer reviewers, and staff have no relevant financial relationships.

Reprints not available from the authors.