A Monocentric Retrospective Cohort of Patients with Severe Atopic Dermatitis Treated with Cyclosporine A in Daily Practice

Daguzé, J.; Aubert, H.; Bernier, C.; Gaultier, Aurélie; Nguyen, Jean–Michel; Stalder, J.‐F.; Barbarot, S.

doi:10.2340/00015555-2689

Cited by 6 publications

(14 citation statements)

References 13 publications

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“…The median ‘drug survival’ of 8 months for CYC reported here is consistent with two recent drug survival studies . In contrast, the median ‘drug survival’ for MTX is estimated at 23 months in this study, more than twice a previous result .…”

Section: Discussionsupporting

confidence: 91%

“…18,19 'Drug survival' can be influenced by various factors: the physician's prescribing behaviours, patient satisfaction, comorbidities, safety profile of the treatment, effectiveness and availability of alternative treatments. 13 As regards the causes of MTX and CYC discontinuation, the proportion of discontinuations for 'disease under control' among patients treated with CYC is lower in the present study than in others (16% vs. 22% and 45%) 15,16 while the proportion of discontinuations for 'disease under control' for patients with MTX is in line with previous findings (55% vs. 49%). 17 This could suggest a higher severity profiles among patients treated with CYC in our population.…”

Section: Discussionsupporting

confidence: 90%

“…As regards the causes of MTX and CYC discontinuation, the proportion of discontinuations for ‘disease under control’ among patients treated with CYC is lower in the present study than in others (16% vs. 22% and 45%) while the proportion of discontinuations for ‘disease under control’ for patients with MTX is in line with previous findings (55% vs. 49%) . This could suggest a higher severity profiles among patients treated with CYC in our population.…”

Section: Discussionsupporting

confidence: 86%

See 2 more Smart Citations

Drug survival and postdrug survival of first‐line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine

Man

Bouzillé

Bénéton

et al. 2018

Acad Dermatol Venereol

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This is the first direct comparison between methotrexate and cyclosporine as first-line immunosuppressive treatments for moderate-to-severe atopic dermatitis in daily practice. We evidenced two different treatment profiles: the duration of methotrexate administration is longer than that of cyclosporine. 'Postdrug survival' could be a new tool to assess the maintenance of effect of a drug after withdrawal in atopic dermatitis, and more broadly in chronic skin disease.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

See 1 more Smart Citation

Drug survival and postdrug survival of first‐line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine

Man

Bouzillé

Bénéton

et al. 2018

Acad Dermatol Venereol

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“…A total of 2, 515 participants were included across the thirty‐eight trials (see Figure for search strategy results and Table for summary of the trials) . Twenty‐three trials included pediatric participants, and of these, ten focused solely on children . There were 510 participants in these ten pediatric trials, with ages ranging from 2 to 18 years.…”

Section: Resultsmentioning

confidence: 99%

Monitoring trough levels in cyclosporine for atopic dermatitis: A systematic review

Blake

Murrell

2019

Pediatric Dermatology

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Background Cyclosporine is a useful immunosuppressive agent for achieving disease control in moderate to severe atopic dermatitis in children and adults. However, it carries the potential for nephrotoxicity. Monitoring of drug levels is performed in other patient groups, such as transplant recipients, but is not commonplace in the management of atopic dermatitis. Objectives To investigate levels of nephrotoxicity associated with cyclosporine use in atopic dermatitis and assess potential correlation with trough levels of cyclosporine. Methods An electronic search was conducted on MEDLINE, EMBASE, and Cochrane databases for randomized controlled trials and cohort studies assessing the safety profile of cyclosporine compared to placebo or other atopic dermatitis treatments, in adult and pediatric atopic dermatitis patients from 1966 to May 2019. Studies that did not assess renal toxicity were excluded from analysis. Results Thirty‐eight trials were included for analysis, excluding 11 that did not assess renal toxicity. Descriptive statistical analysis only was performed, due to the high heterogeneity between study methodologies. Significant renal toxicity was seen in 0%‐9% of pediatric participants. Monitoring of trough cyclosporine levels was performed in only 10 of the studies, and their correlation to toxicity or disease activity was not explored. Conclusion There is limited evidence in atopic dermatitis regarding trough level monitoring of cyclosporine. Currently, the practice is not commonplace, particularly in pediatrics, and this is reflected in trial methodology. Monitoring may be useful in specific pediatric groups, such as those on multiple concurrent medications, patients with hepatic or renal dysfunction and non‐responders to therapy.

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“…A few studies focused on DS in AD (only two children included). The median DS of 12 months for CIC as first‐line IST is slightly longer than in previous studies . However, they were conducted in adults or in both adults and children.…”

Section: Determinants Of ‘Drug Survival’ (First‐ and Second‐line) Andmentioning

confidence: 99%

Drug survival and postdrug survival of systemic treatments in a national French cohort of children with atopic dermatitis

et al. 2020

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A Monocentric Retrospective Cohort of Patients with Severe Atopic Dermatitis Treated with Cyclosporine A in Daily Practice

Cited by 6 publications

References 13 publications

Drug survival and postdrug survival of first‐line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine

Drug survival and postdrug survival of first‐line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine

Monitoring trough levels in cyclosporine for atopic dermatitis: A systematic review

Drug survival and postdrug survival of systemic treatments in a national French cohort of children with atopic dermatitis

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