Tacrolimus hydrate (FK506): therapeutic effects and selection of responders in the treatment of myasthenia gravis

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

“…In addition to synthetic glucocorticoids (GCs), more powerful immunosuppressive drugs including cyclosporine and tacrolimus have been applied to such patients [1][2][3][4][5][6][7]. However, individual variations in the clinical efficacy of immunosuppressive drugs have been observed, and thus the drugs are not always a satisfactory solution for the treatment of patients [8][9][10][11].…”

Tacrolimus in refractory patients with myasthenia gravis: Coadministration and tapering of oral prednisolone

“…In such cases tacrolimus is the next candidate drug following the guidelines approved by the Ministry of Public Health, Welfare and Labor of Japan. [2][3][4][5] This agent is classified as an immunosuppressant, which acts as a calcineurin inhibitor, and selectively and reversibly suppresses helper T cells secreting cytokines such as interleukin-2. 6,7 To prospectively investigate therapeutic and harmful effects of tacrolimus, this drug was given to seven refractory patients with MG, including a non-thymectomized one, with or without coadministration of oral prednisolone and anti-cholinesterase agents.…”

Five-year follow-up with low-dose tacrolimus in patients with myasthenia gravis

“…By contrast, no serious adverse events have been associated with tacrolimus treatment of MG for 16 weeks [8,9], 6-32 months [14], 1 year [13], more than 2 years [16], 88-104 weeks [12], or 36 months [17]. Ponseti et al reported 3 patients with solid tumors; however, these events were unlikely to be caused by tacrolimus because of the short interval between start of treatment and diagnosis of malignancy [4].…”

“…However, the efficacy and safety of long-term tacrolimus treatment for MG have not been established. There have been several early reports of the effects of tacrolimus, including studies in Japan; however, these studies only evaluated short-term effects, for example over 16 weeks [8,9]. We report here the efficacy and safety of long-term treatment with tacrolimus (5-year follow-up) in 9 patients.…”