Ann Dermatol.  2018 Apr;30(2):143-149. 10.5021/ad.2018.30.2.143.

Risk Factors Affecting Adverse Effects of Cyclosporine A in a Real-World Psoriasis Treatment

• Kim BR
• Yang S
• Doh EJ
• Choi CW
• Youn SW

• KMID: 2414674
• DOI: http://doi.org/10.5021/ad.2018.30.2.143

Abstract

BACKGROUND
No study to date has focused on the changes in laboratory test results and related risk factors in patients with psoriasis treated with prolonged Cyclosporine A (CsA) therapy.
OBJECTIVE
The objective of this study was to investigate the changes of laboratory values and related risk factors in patients with psoriasis treated with CsA in a real-world setting.
METHODS
Records of patients with psoriasis treated with CsA at an outpatient clinic were collected, and a Cox proportional hazards regression model was used.
RESULTS
Of the 128 patients included in this study, 28 patients (21.9%) showed laboratory test abnormalities over a mean medication period of 11.6 months. Older age (hazard ratio [HR], 1.174; 95% confidence interval [CI], 1.068~1.370; p=0.007) and pre-existing kidney disease (HR, 0.008; 95% CI, 0~0.205; p=0.001) significantly increased the risk of renal dysfunction. Male sex was the only significant risk factor for liver enzyme elevation (HR, 0.284; 95% CI, 0.081~0.784; p=0.026) and uric acid abnormality (HR, 0.048; 95% CI, 0~0.372; p=0.046).
CONCLUSION
This is an in-depth analysis of laboratory changes and related risk factors in patients with psoriasis treated with CsA. Liver is the most commonly affected organ of CsA toxicity. Older age, male sex, and presence of kidney disease were risk factors associated with laboratory abnormality during CsA treatment.

Keyword

Adverse effects; Clinical laboratory techniques; Cyclosporine; Psoriasis; Risk factors

MeSH Terms

Ambulatory Care Facilities
Clinical Laboratory Techniques
Cyclosporine*
Humans
Kidney Diseases
Liver
Male
Psoriasis*
Risk Factors*
Uric Acid
Cyclosporine
Uric Acid

Figure

• 

  Fig. 1 Cumulative hazard ratio of the development of laboratory abnormalities adjusted for the effect of sex and the presence of kidney disease. Laboratory abnormalities tended to occur prior to 400 days of treatment.

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