Zdravljenje bolnikov z od glukokortikoidov odvisno astmo z majhnimi odmerki ciklosporina
Treatment of steroid dependent asthmatics with low doses of cyclosporine

slovenian

2004

volume 73, issue 1

Asthma   Cyclosporine   Drug Therapy   Dyspnea   Glucocorticoids, Synthetic   Peak Expiratory Flow Rate   Randomized Controlled Trials   therapy   Treatment Outcome

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. Asthmatics with glucocorticoid dependent asthma should be treated with systemic steroids. Cyclosporine is in many ways a potent anti-inflammatory drug. Cyclosporine is sometimes very effective in treating asthmatics and could allow us to lower the dose of oral steroid. In some randomized, double blind studies steroid dependent asthmatics were treated 12-36 weeks with cyclosporine in dose 5 mg/kg/day. We tried cyclosporine in steroid dependent asthmatics in shorter course and in lower dose. Methods. 13 steroid dependent asthmatics were in the first four weeks of the study treatedby their own drugs (phase 1). Then they were for the next four weeks (phase 2) randomly and in double blind fashion treated with either cyclosporine (mean 1.7 mg/kg/day, SD 0.5, 6 patients - group 1) or by identical placebo (7patients - group 2). To the patients in the group 2 serum concentration of cyclosporine was measured on the eight day of the study. Results. Morning peak expiratory flow (PEF) raised significantly in group 1 (200 L/sec to 247 L/sec or for 23%). Patients in group 1 had significantly less episodes of nocturnal asthma (2.2 episodes/night to 1.5 episodes/night orfor 32%). In group 2 were not found any changes between first phase and second phase of the study. Steroid consumption did not change in any group. Mean serum concentration of cyclosporine in patients of groupl was 35.7 microg/L. We did not find any adverse effects of cyclosporine or placebo. Conclusions. Cyclosporine could have dangerous side effects, which are dependent on its serum concentration. So it should be administered in the lowest possible dose and for the most possible short period. (Abstract truncated at 2000 characters).

10.04.2014