S Schmidt1, U Pleyer. 1. Universitätsaugenklinik, Campus Virchow der Charité-Universitätsmedizin, Berlin. st-st.st@ web.de
Abstract
BACKGROUND: Cyclosporine (CsA) is a widely used drug in the treatment of posterior uveitis. Whereas treatment with CsA has considerably improved the visual prognosis of uveitis patients, the therapeutic benefits of CsA are partially outweighed by its adverse effects, most notably nephrotoxicity and hypertension. Recently, monitoring the CsA 2-h postdose level (C(2)) has been recommended as the most sensitive assay and predictor of clinical outcome in transplantation. PATIENTS AND METHODS: This prospective clinical trial included 15 patients with posterior uveitis who received oral CsA (5 mg/kg BW b.i.d.). The relationship of C(2) to C0 blood levels was analyzed and correlated with clinical safety and efficacy. RESULTS: A high intrapatient and interpatient variability was observed regarding the C0 values depending on several factors including comedication and intestinal resorption. C(2) values corresponded to control measurements of intraocular inflammation. CONCLUSIONS: C(2) monitoring offers a simple and accurate alternative for clinical monitoring of CsA. It allows the dose of CsA to be individualized effectively for each patient.
BACKGROUND:Cyclosporine (CsA) is a widely used drug in the treatment of posterior uveitis. Whereas treatment with CsA has considerably improved the visual prognosis of uveitispatients, the therapeutic benefits of CsA are partially outweighed by its adverse effects, most notably nephrotoxicity and hypertension. Recently, monitoring the CsA 2-h postdose level (C(2)) has been recommended as the most sensitive assay and predictor of clinical outcome in transplantation. PATIENTS AND METHODS: This prospective clinical trial included 15 patients with posterior uveitis who received oral CsA (5 mg/kg BW b.i.d.). The relationship of C(2) to C0 blood levels was analyzed and correlated with clinical safety and efficacy. RESULTS: A high intrapatient and interpatient variability was observed regarding the C0 values depending on several factors including comedication and intestinal resorption. C(2) values corresponded to control measurements of intraocular inflammation. CONCLUSIONS:C(2) monitoring offers a simple and accurate alternative for clinical monitoring of CsA. It allows the dose of CsA to be individualized effectively for each patient.
Authors: B D Kahan; J Dunn; C Fitts; D Van Buren; D Wombolt; R Pollak; R Carson; J W Alexander; M Choc; R Wong Journal: Transplantation Date: 1995-02-27 Impact factor: 4.939
Authors: Edward Cole; Nava Maham; Carl Cardella; Daniel Cattran; Stanley Fenton; Jayne Hamel; Catherine O'Grady; Robert Smith Journal: Transplantation Date: 2003-06-27 Impact factor: 4.939