Cyclosporine use in miscellaneous clinical settings other than organ transplantations: is there any evidence for target levels?
H. Tesfaye, R. Prusa, B. Jedlickova, J. Segethova
Ann Transplant 2008; 13(1): 40-40
Background: Cyclosporine is a corner stone in organ transplantation, its benefit has been proved for decades. In the long-term therapy, its use is expanded to other clinical conditions despite the lacking profound evidence of its advantage. The aim was to evaluate differences in trough blood levels of cyclosporine in some clinical indications other than transplantation.
Material/Methods: Blood cyclosporine trough levels determined by ï¬‚uorescent polarization immunoassay (FPIA) TDx Abbott Diagnostics for TDM purpose in one year period was pooled from laboratory data-base. Total of 304 levels from 45 patients (26 males: 19 females) aged 2-62 years, who were on oral cyclosporine daily maintenance dose for conditions like systemic lupus erythematosus (SLE), atopic dermatitis (ADS), idiopathic thrombocytopenic purpura (ITP), dermatopolymyositis (DMS), and cardiomyopathy (CMP) were included.
Results: Cyclosporine trough concentration was undetectable in 27 cases, with maximum1213 μg/L, mode 74 μg/L, median 91 μg/L, mean 104.4±119.5 μg/L SD, and SE 6.85 respectively. Despite poorly defi ned target, most clinicians desired trough concentrations not exceeding 100 μg/L, aiming to reduce toxicity using averagely dose of 200 mg daily. In this respect, nearly 35% were above this point, whereas about 8% were below the detection limit of the method and doing well and no significant difference in concentrations within diagnostic groups except for ADS versus ITP was noted (p
Keywords: Cyclosporine, renal cell carcinoma, gallbladder, metastasis, Organ Transplantation