C1-C2 point monitoring of low-dose cyclosporin A given as a single daily dose in children with steroid-dependent relapsing nephrotic syndrome

Effective Treatment with Cyclosporine A of a Child with Systemic Lupus Erythematosus Resistant to Cyclophosphamide Pulse Therapy

“…We have previously demonstrated that administration of CsA as a single daily, even if low, dose is optimal for obtaining maximum efficacy and minimum toxicity in patients with steroid-dependent nephrotic syndrome (Nakahata et al 2005). Therefore, in our present case with SLE, we administered CsA at the initial dose of 1.8 mg/kg daily as a single dose, since the optimal dose of the drug for the treatment of SLE still remains to be clarified.…”

“…Therefore, CsA administration was initiated at 75 mg (1.8 mg/kg) daily, administered as a single-dose (Nakahata et al 2005), with PSL at the dose of 15 mg daily, in place of IVCY. The trough blood level of CsA remained between 25 and 32 ng/ml, and the peak blood level was 959 ng/ml.…”

Renal Biopsy Findings in Children Receiving Long-Term Treatment with Cyclosporine A Given as a Single Daily Dose

“…Since CsA nephrotoxicity remains a major problem in CsA treatment (Habib and Niaudet 1994;Inoue et al 1999;Iijima et al 2002), in this study, we investigated the safety, from the histological standpoint, of long-term CsA treatment with the drug administered daily as a single-dose while maintaining the peak (between 1 and 2 hrs post-dosing, C 1 -C 2 ) blood level at around 800 ng/ ml, in children with NS and some rheumatic diseases Nakahata et al 2005;Tanaka et al 2005).…”

“…From January 2002 to December 2004, 16 children with SDNS, SRNS and X-linked immune dysregulation, polyendocrinopathy and enteropathy (IPEX) were treated at the Department of Pediatrics, Hirosaki University Hospital, with CsA (Neoral) given as a single daily dose while maintaining the C 1 -C 2 (between 1 and 2 hours postdosing) blood level at around 800 ng/ml Kudo et al 2005;Nakahata et al 2005). Of these, the records of all the 7 children with NS (5 with SDNS and 2 with SRNS) and the child with IPEX, in whom posttreatment renal biopsy could be conducted after long-term treatment with CsA according to our treatment protocol (mean, 20 months; range, 9-36 months) were retrospectively evaluated.…”

“…Measurement of the blood CsA levels was performed every 4 weeks during the study period. The dose was subsequently adjusted to achieve a C 1 -C 2 blood level of approximately 600-800 ng/ml in the SDNS patients Nakahata et al 2005), and around 800 ng/ml in the SRNS patients and the IPEX patient Tanaka et al 2005). We have confirmed in a previous study that most NS children given Neoral ® before breakfast show a stable absorption profile of the drug, and also reported that the peak blood levels of the drug are usually achieved between 1 and 2 hrs post-dosing.…”