Drug survival of cyclosporine in the treatment of hand eczema: a multicentre, daily use study.
BACKGROUND
Hand eczema is a common condition; it is often chronic and can be difficult to treat. Cyclosporine is used off-label to treat severe hand eczema; however, the evidence for this treatment is scarce.


OBJECTIVE
To examine the drug survival of cyclosporine in a daily practice cohort of patients with chronic hand eczema.


METHODS
This retrospective daily use study included hand eczema patients who were treated with cyclosporine between 01-06-1999 and 01-06-2014 in two Dutch university hospitals. Patient and treatment characteristics were retrospectively collected from medical charts. First treatment episodes were analysed by means of Kaplan-Meier drug survival curves. Possible determinants of drug survival were analysed by Cox regression models. Treatment effectiveness was analysed with a retrospective physician's global assessment.


RESULTS
A total of 102 patients were treated with cyclosporine. The median drug survival rate was 0.86 years (10.3 months). The overall drug survival rate after 6 months, 1, 2 and 3 years were 61.7%, 45.2%, 18.6% and 13.9% respectively. Main reasons for discontinuation were adverse events, especially early in treatment, and ineffectiveness. After 3 months, a good response to treatment was recorded in 62.9% of the patients.


CONCLUSIONS
Cyclosporine had a median drug survival of 10.3 months. Especially patients with recurrent vesicular hand eczema showed a good treatment response.
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
W A
WA
Christoffers
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
K
K
Politiek
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
P J
PJ
Coenraads
Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
J
J
van der Schaft
Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
M S
MS
de Bruin-Weller
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
M L A
ML
Schuttelaar
D016572:Cyclosporine / Q000627:therapeutic use*; D004485:Eczema / Q000188:drug therapy*; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D056687:Off-Label Use; D010328:Patch Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
D016572:Cyclosporine