2012
DOI: 10.1097/aci.0b013e32835571f6
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Calcineurin inhibitors in chronic urticaria

Abstract: For CIU patients refractory to antihistamines, low-dose cyclosporine therapy (<3 mg/kg per day) with appropriate laboratory monitoring provides an alternative with an acceptable side-effect profile. Long-term (>12 months) moderate-dose (2.5-5 mg/kg per day) cyclosporine treatment may cause longitudinal increases in serum creatinine. However, decreasing or stopping cyclosporine dosing reverses measured nephrotoxicity in the vast majority of patients, and some patients with careful monitoring can tolerate very l… Show more

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Cited by 22 publications
(7 citation statements)
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“…Acutely, corticosteroids are the most widely used therapy for antihistamine refractory CIU; however, due to toxicity this therapy is usually reserved for short-term use in refractory or severe disease (7, 8). Other alternative agents for CIU have been investigated, notably leukotriene modifiers, cyclosporine and more recently Omalizumab, but use of other potentially useful medications is limited by lack of available studies (9, 10). Dapsone is a sulfone antibiotic with immunomodulatory properties which has shown promise in antihistamine refractory CIU, but to date has been limited by the evidence quality (6).…”
Section: Introductionmentioning
confidence: 99%
“…Acutely, corticosteroids are the most widely used therapy for antihistamine refractory CIU; however, due to toxicity this therapy is usually reserved for short-term use in refractory or severe disease (7, 8). Other alternative agents for CIU have been investigated, notably leukotriene modifiers, cyclosporine and more recently Omalizumab, but use of other potentially useful medications is limited by lack of available studies (9, 10). Dapsone is a sulfone antibiotic with immunomodulatory properties which has shown promise in antihistamine refractory CIU, but to date has been limited by the evidence quality (6).…”
Section: Introductionmentioning
confidence: 99%
“…There was considerable variability in initial ciclosporin dosing in the present study and reasons for dose changes were not recorded. Guidelines do not recommend a dose of ciclosporin in CSU but initiating patients on a low dose and up-titrating is an approach that has been advocated to minimise adverse effects while preserving efficacy [ 15 ]. Alternatively, studies have used doses of up to 4 mg/kg [ 16 ], with 3 mg/kg commonly reported as being effective and tolerable [ 17 ] even for long periods [ 18 ].…”
Section: Discussionmentioning
confidence: 99%
“…A resposta ao tratamento variou de 40 a 100%, e aqueles estudos com uso de ciclosporina por períodos curtos foram os que apresentaram menores taxas de resposta e maior recorrência da urticária. Nos estudos com pacientes que responderam à terapia com ciclosporina, 37% apresentaram remissão da doença 6 .…”
Section: Discussionunclassified
“…A ciclosporina parece ser um medicamento seguro quando utilizado em doses baixas (3 mg/kg por dia) para pacientes com UCE refratária aos anti-histamí-nicos. Entretanto, os pacientes devem ser avaliados, previamente à introdução da ciclosporina, quanto às contraindicações, como hipertensão arterial, doença renal, gravidez, amamentação e história prévia de neoplasia 6 .…”
Section: Introductionunclassified