A body-weight-independent dosing regimen of cyclosporine microemulsion is effective in severe atopic dermatitis and improves the quality of life

被引:70
作者
Czech, W
Bräutigam, M
Weidinger, G
Schöpf, E
机构
[1] Novartis Pharma GmbH, Nurnberg, Germany
[2] Univ Freiburg, Dept Dermatol, D-7800 Freiburg, Germany
关键词
D O I
10.1016/S0190-9622(00)90180-4
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Cyclosporine has shown to be effective in severe atopic dermatitis. Little has been reported on the new microemulsion form (Sandimmune, Neoral) in the treatment of this disease. Also, it has not been investigated whether a body-weight-independent dosing regimen of cyclosporine is appropriate for the treatment of atopic dermatitis. Objective: The goal of this study was to investigate a body-weight-independent dosing regimen of cyclosporine microemulsion in severe atopic dermatitis by comparing high and low starting doses of treatment. Methods: A total of 106 adults with severe atopic dermatitis were enrolled in this double-blind study and randomized to receive a starting dose of either 150 mg (low) or 300 mg (high) of cyclosporine microemulsion daily. After 2 weeks the dose could be reduced by 50% if the clinical symptom score was reduced by 50% or more. After 8 weeks the responders entered a 4-week follow-up phase and were randomized to either stop treatment or to continue on their last effective dose every second day. Results: After 2 weeks of treatment the total symptom score decreased from 59.0 to 39.3 with 150 mg and from 60.7 to 33.2 with 300 mg cyclosporine (P<.05). Until week 8 there was a further decrease in the clinical symptom score to 30.8 with low-dose therapy and 25.5 with high-dose therapy Similar positive effects could be observed in assessments of affected body surface area, itching, sleep loss, and quality of life. At week 2, there was an increase of 0.6% in serum creatinine in patients receiving 150 mg, and 5.8% in the 300 mg group (P<.01). At week 8, the effect on serum creatinine was similar, with a 1.1% rise in the low dose group and a 6.0% increase in the high dose group. Body weight had no influence on efficacy or tolerability in this study. Conclusion: Body-weight-independent dosing with cyclosporine seems to be feasible in the short-term treatment of severe atopic dermatitis. Although the starting dose of 300 mg/day is more effective than 150 mg/day, the 150 mg dose would be preferable for the initiation of therapy because of its excellent renal tolerability.
引用
收藏
页码:653 / 659
页数:7
相关论文
共 15 条
[1]  
[Anonymous], ACTA DERM VENERE S92, DOI [10.2340/00015555924447, DOI 10.2340/00015555924447]
[2]   Long-term efficacy and safety of cyclosporin in severe adult atopic dermatitis [J].
BerthJones, J ;
GrahamBrown, BAC ;
Marks, B ;
Camp, RDR ;
English, JSC ;
Freeman, K ;
Holden, CA ;
Rogers, SCF ;
Oliwiecki, S ;
Friedmann, PS ;
LewisJones, MS ;
Archer, CB ;
Adriaans, B ;
Douglas, WS ;
Allen, BR .
BRITISH JOURNAL OF DERMATOLOGY, 1997, 136 (01) :76-81
[3]   WEIGHT-INDEPENDENT DOSING OF CYCLOSPORINE - AN ALTERNATIVE TO THE MG/KG DOCTRINE [J].
BOCK, HA ;
KAMBER, V ;
BRUNNER, FP ;
THIEL, G .
TRANSPLANTATION, 1994, 57 (10) :1484-1489
[4]  
DIEPGEN TL, 1991, DERMATOS BER UMWELT, V39, P79
[5]   DERMATOLOGY LIFE QUALITY INDEX (DLQI) - A SIMPLE PRACTICAL MEASURE FOR ROUTINE CLINICAL USE [J].
FINLAY, AY ;
KHAN, GK .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 1994, 19 (03) :210-216
[6]  
FINLAY AY, 1996, J EUR ACAD DERMATOL, V7, P149
[7]  
GRANLUND H, 1994, J DERMATOL TREAT S1, V5, P8
[8]   The occurrence of atopic dermatitis in North Europe: An international questionnaire study [J].
Larsen, FS ;
Diepgen, T ;
Svensson, A .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1996, 34 (05) :760-764
[9]   INFLUENCE OF A FAT-RICH MEAL ON THE PHARMACOKINETICS OF A NEW ORAL FORMULATION OF CYCLOSPORINE IN A CROSSOVER COMPARISON WITH THE MARKET FORMULATIONS [J].
MUELLER, EA ;
KOVARIK, JM ;
VANBREE, JB ;
GREVEL, J ;
LUCKER, PW ;
KUTZ, K .
PHARMACEUTICAL RESEARCH, 1994, 11 (01) :151-155
[10]   PHARMACOKINETICS AND TOLERABILITY OF A MICROEMULSION FORMULATION OF CYCLOSPORINE IN RENAL-ALLOGRAFT RECIPIENTS - A CONCENTRATION-CONTROLLED COMPARISON WITH THE COMMERCIAL FORMULATION [J].
MUELLER, EA ;
KOVARIK, JM ;
VANBREE, JB ;
LISON, AE ;
KUTZ, K .
TRANSPLANTATION, 1994, 57 (08) :1178-1182