To retrospectively evaluate safety and efficacy of long-term treatment with Cyclosporine A (CSA) in patients with systemic lupus erythematosus (SLE) poorly responsive to treatment with corticosteroids (CCS) and/or conventional disease-modifying anti-rheumatic drugs (DMARDs), SLE patients who had received CSA-based induction and maintenance regimens according to disease activity were recorded. Efficacy was assessed using the SLE Disease Activity Index (SLEDAI) and laboratory analyses. Forty SLE patients [including 18 with lupus nephritis, 11 with neurological involvement and 7 with overlap syndromes (4 Sjögren's syndrome, 2 myasthenia gravis and 1 Behçet's disease)] were recorded. According to baseline SLEDAI, 30 patients had severe and 10 moderate SLE. Mean SLEDAI scores and relevant laboratory values significantly reduced from baseline (22±10 vs 5±6; P < 0.002) during the follow-up period (8±2 years; range 1-15). Twenty-three (57.5%) patients achieved excellent (improvement in the range 70-100%) response to treatment (10 of whom were subsequently maintained on CSA monotherapy), 14 (35%) had good/fair (improvement in the range 25-69%) response and 3 (7.5%) had to interrupt therapy (including CSA) for disease worsening. Mild and transient adverse events occurred in 15 (37%) patients, including hypertrichosis (17.5%), gum hypertrophy (17.5%) hypertension (12.5%), abdominal pain (7.5%), and dyslipidemia (5%), but treatment interruption was not required. Low-dose CSA together with other drugs is effective to induce, or as monotherapy to maintain, long-term (at least 2 years) remission, and is generally well tolerated in patients with moderate or severe SLE poorly responsive to CCS and/or conventional DMARDs. Furthermore, the favourable effect of CSA treatment may allow to spare more cytotoxic drugs. Copyright © by BIOLIFE, s.a.s.
|Titolo:||Cyclosporine A in the long-term management of systemic lupus erythematosus|
|Data di pubblicazione:||2011|
|Appartiene alla tipologia:||01a Articolo in rivista|