title: Long-term treatment of systemic lupus erythematosus with cyclosporin A.
abstract: OBJECTIVE
  To evaluate the efficacy of long-term treatment with cyclosporin A (CSA) in systemic lupus erythematosus (SLE).
  
  
  METHODS
  Thirty patients with SLE whose condition was either poorly responsive or unresponsive to treatment with steroids and/or cytotoxic drugs were enrolled in a prospective, nonrandomized study of CSA. Patients with hypertension or hypercreatinemia were excluded. Disease activity was evaluated according to the systemic lupus activity measure. Assessments were made prior to study entry and after 6, 12, 18, and 24 months.
  
  
  RESULTS
  Twenty-seven patients completed at least 24 months of treatment with CSA. The mean disease activity score significantly decreased after 6 months of therapy (P < 0.01); this result was maintained throughout the study. A conspicuous steroid-sparing effect was observed following administration of CSA (P < 0.01). Side effects included hypertrichosis (63% of patients), paresthesias (23%), gastrointestinal symptoms (20%), gingival hyperplasia (17%), hypertension (10%), tremors (7%), and nephrotoxicity (13%). No significant changes in serum creatinine levels were observed.
  
  
  CONCLUSIONS
  CSA represents a helpful second-choice treatment for patients with active SLE. Administration of CSA necessitates expert and careful followup of patients.
authors.affiliation: University La Sapienza, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Caccavo
authors.forename: B
authors.initials: B
authors.lastname: Laganà
authors.forename: A P
authors.initials: AP
authors.lastname: Mitterhofer
authors.forename: G M
authors.initials: GM
authors.lastname: Ferri
authors.forename: A
authors.initials: A
authors.lastname: Afeltra
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
authors.forename: L
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D007107:Immune System / Q000187:drug effects / Q000503:physiopathology; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine