An audit of cyclosporin for systemic lupus erythematosus and related overlap syndromes: limitations of its use.
OBJECTIVE
To establish the usefulness of cyclosporin for systemic lupus erythematosus (SLE) in a routine clinical setting.


METHODS
Patients who had received cyclosporin for SLE, mixed connective tissue disease, and other overlap syndromes were identified. Data relating to treatment with cyclosporin, including dosage, concurrent steroid use, response to treatment, side effects, and reasons for withdrawal, were extracted from medical notes.


RESULTS
A total of 43 patients had been treated with cyclosporin between 1995 and 1998. Cyclosporin, average dose 4 mg/kg/d, was started in patients whose disease was active despite previous use of alternative second line agents. On every occasion when cyclosporin was used for thrombocytopenia the response was good, but when arthritis was the indication, the response was good in 14/26. The success rates for symptoms of arthralgia, myalgia, and fatigue were lower. Side effects occurred in 28/43 (65%) cases, and on 39/47 (83%) occasions cyclosporin was withdrawn owing to either side effects or failure to control disease activity, after a median duration of treatment of only four months.


CONCLUSIONS
The response to cyclosporin is mixed and usually short lived.
Morton
S J
SJ
Clinical Immunology Unit, University Hospital, Queens Medical Centre, Nottingham, UK.
Powell
R J
RJ
D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D016572:Cyclosporine