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. 2010 Feb;22(1):9-15.
doi: 10.5021/ad.2010.22.1.9. Epub 2010 Feb 28.

The Efficacy and Safety of Long-term Oral Cyclosporine Treatment for Patients with Atopic Dermatitis

Sik Haw  1 , Min-Kyung Shin, Choong-Rim Haw
Affiliations

The Efficacy and Safety of Long-term Oral Cyclosporine Treatment for Patients with Atopic Dermatitis

Sik Haw et al. Ann Dermatol. 2010 Feb.

Abstract

Background: Steroids are used in conventional treatment of atopic dermatitis (AD) and they are very effective for improving the symptoms, but they also have several complications. Many studies have reported that short-term use of cyclosporine (CsA) is effective for severe AD as a substitute for steroid. However, there are very few studies on the long-term use of CsA for AD in the Korean population.

Objective: The purpose of this study was to investigate whether long-term CsA therapy is effective and safe for treating AD.

Methods: We performed a retrospective study of the patients with AD and who were treated with CsA at Kyung Hee Medical Center between January 2001 and February 2008. Among 147 patients, 61 received CsA treatment for more than 6 months. To evaluate the efficacy of CsA treatment, the objective SCORAD was checked for all 61 patients at every visit. Extensive laboratory tests were performed every two months to assess the safety of treatment.

Results: The mean duration of CsA treatment was 13.5+/-8.4 months and the mean initial dose of CsA was 2.7+/-0.9 mg/kg/day. The mean objective SCORAD values significantly decreased from 34.1+/-11.2 at baseline to 11.4+/-10.7 after 6-month of CsA treatment (p<0.05). A significant decline of the SCORAD score was observed starting from 1-month of CsA treatment. The mean duration of remission was 4.5+/-2.9 months. A total of 13 adverse events in 10 patients were recorded during the study period. One patient dropped out due to renal dysfunction. Elevation of peripheral blood pressure was noted in 8 patients. Three patients complained of gastrointestinal troubles, and one patient had hypertrichosis, but the problems of these 4 patients were mild and easily treated.

Conclusion: We suggest that long-term, low-dose CsA treatment is safe and effective for patients who suffer from AD.

Keywords: Atopic dermatitis; Cyclosporine; Long-term treatment.

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Figures

Fig. 1
Fig. 1
The changes of the SCORAD score according to cyclosporine treatment. Each level of the SCORAD score after 1 month, 2 months, 4 months and 6 months of cyclosporine treatment was significantly different from the baseline score (p<0.05).
Fig. 2
Fig. 2
The changes of the SCORAD score according to the severity of AD. Each level of the SCORAD score in both the moderate (n=12) and severe groups (n=49) after 1 month, 2 months, 4 months and 6 months of cyclosporine treatment was significantly different from the baseline score (p<0.05).
Fig. 3
Fig. 3
The changes of the SCORAD score according to the age groups. Each level of the SCORAD score for both childhood (n=13) and adult AD (n=48) after 1 month, 2 months, 4 months, and 6 months of cyclosporine treatment was significantly different from the baseline score (p<0.05).
Fig. 4
Fig. 4
Comparison of the SCORAD score between the intrinsic (n=12) and extrinsic AD (n=41). There was no significant difference in the efficacy of cyclosporine treatment between the intrinsic and extrinsic groups.
Fig. 5
Fig. 5
The changes of the total serum IgE levels in the extrinsic atopic dermatitis patients according to the cyclosporine treatment. The serum IgE was significantly decreased after treatment (*p<0.05).
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