Long-term Safety of Cyclosporine in the Treatment of Psoriasis

The use of cyclosporine in dermatology: Part II

“…In another study of long-term therapy in 122 patients the median time to development of hypertension was 55 months. 88 The onset of hypertension in this group was shown to be bimodal, with a peak during the first 9 months of therapy and again after 36 months. In the pooled analysis by Feutren et al, 79 a significant increase in diastolic blood pressure was detected after 1 month of treatment compared to controls, but no further increase was seen between months 1 and 3.…”

“…140 There is considerable variability in there reported incidence of hypertrichosis (Table II). Hypertrichosis was reported in 6.8% of patients in the study by Krupp et al,114 23% in that of Grossman et al 88 and in 54% in a study by Griffiths et al 141 This side effect is more cosmetically unacceptable for women with darker hair. The etiology is unknown with no evidence to suggest an alteration in endocrine status.…”

“…87 Other risk factors for cyclosporine-induced nephropathy include preexisting or new-onset hypertension, renal conditions, other nephrotoxic medications, older age, and obesity. 64,65,88 Recommendations…”

Gingival Enlargement Induced by Drugs

“…The use of different oral formulations of cyclosporin (liquid mixture, soft capsules or new microemulsion capsules) does not seem to influence the incidence of gingival overgrowth.f 56 ,66) Gingival enlargement has also been observed when cyclosporin has been used for the treatment of other diseases (e.g. dermatological [67] and neurological [55] disorders).…”

Adverse events from systemic therapies for psoriasis are common in clinical practice

“…There is also a wide range of frequencies regarding blood cell dyscrasias, from 0.4% to 34.6% (18)(19)(20)(21). Cyclosporine has some observational data which, for the most part, resemble the trial data with the exception that the numbers of subjects are typically smaller and there was more evidence of renal dysfunction as evidenced by increased serum creatinine (10-44%) (23)(24)(25)(26)(27)(28)(29)(30)(31). However, consensus statements, which are helpful, are only necessary when there is uncertainty; this is reflected by the fact that much of the available information is based on case reports and limited observational studies.…”