Trial of cyclosporin in corticosteroid-dependent chronic severe asthma

Difficult asthma

“…The use of methotrexate and cyclosporine A has been examined in oral glucocorticosteroid-dependent asthmatics in double-blind placebo-controlled studies and a significant oral glucocorticosteroid-sparing effect have been found (83,84). However, these medications are potentially toxic and cannot be generally recommended at present due to their unfavorable risk-benefit ratio.…”

Asthma that is unresponsive to usual care

“…Methotrexate, gold and cyclosporin A have corticosteroid-sparing effects clinically that must be weighed against a serious adverse effect profile. [46][47][48][49][50][51][52][53][54] For example, low-dose oral methotrexate therapy, widely used in the treatment of rheumatologic diseases, has been reported to reduce the need for systemic corticosteroids in severe asthma, but study results have been inconsistent. 46−50 A few patients have been reported to benefit from oral gold therapy, 53,54 and intravenous immunoglobulin has been reported to be of benefit, but only in uncontrolled studies.…”

Bronchial Asthma Developing after 15 Years of Immunosuppressive Treatment Following Renal Transplantation

“…Cyclosporine exerts immunosuppressive and antiinflammatory actions by inhibiting activated T cells as its primary mode of efficacy in steroid-dependent bronchial asthma (10,11). In addition, it plays an important role, not only in the suppression of organ transplantation rejection (12), but also in the treatment of autoimmune diseases (13).…”

“…On the other hand, since the 1990s, various immunosuppressive medicines, including methotrexate (5), azathioprine (AZA) (6), cyclosporine (CsA) (7,8) and troleadomycin (9) have been applied to treat steroid-dependent severe bronchial asthma in order to reduce the use of systemic corticosteroids. These immunosuppressive medicines are thought to inhibit T cell activation in the chronic airway inflammation that occurs in bronchial asthma (10,11). The current patient had received immunosuppressive therapy, including CsA and AZA, for 15 years due to undergoing renal transplantation.…”