Drawbacks

In a retrospective study of 122 consecutive patients given ciclosporin for psoriasis at a dose not exceeding 5 mg/kg/day for between 3 and 76 months, impairment of renal function, as evidenced by an increase in serum creatinine levels to >30% above the baseline value, occurred in 53 (43%) patients after a median treatment time of 23 months.66 Hypertension developed in 29 (24%) patients after a median treatment time of 53 months. The risk of having to discontinue therapy because of side-effects rose to 41% (± 6-7%) by 48 months. This risk increased with the age of the patient and with pre-existing hypertension or high serum creatinine levels. In a smaller study of 20 patients who had received ciclosporin for an average of 6 years (range 5-8 years), nine (45%) developed persistent increases in serum creatinine of >30% from baseline and five (25%) showed persistent increases of >50%. The renal glomerular filtration rate showed a persistent decrease of >30% in seven patients and of >50% in two patients.67

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