Diltiazem co treatment with cyclosporine for induction of disease remission in sight-threatening non-infectious intraocular inflammation

Abstract

Purpose: To investigate the effects of diltiazem co-treatment with microemulsified cyclosporine-A (CsA) on dosage, blood concentrations of CsA, as well as therapeutic and side effects in patients with sight-threatening non-infectious intraocular inflammation.

Methods: A prospective, randomized, placebo-controlled, open-label trial of 39 patients with sight-threatening non-infectious intraocular inflammation. The change in visual acuity (LogMAR), the grade of inflammatory activity, therapeutic concentration of CsA in the blood and systemic and renal toxicity were determined after comparing two groups, one treated with CsA and diltiazem (treatment group), and the other without diltiazem (control group).

Results: Compared with the control group, the concentration of CsA in the blood of the treatment group significantly increased (P < 0.05) requiring a reduction in dosage of CsA (P < 0.05).

Conclusion: In patients with severe intraocular inflammation treated with CsA and diltiazem, blood concentrations of CsA increased as the dosage decreased. This efficient combination therapy reduced patient's economic burden, at the same time decreasing systemic and renal toxicity which in turn may promote the use of CsA for longer periods.

Keywords: Cyclosporine; Diltiazem; Intraocular inflammation; Renal toxicity; Uveitis.