抄録
We studied retrospectively the relationship between the clinical effect of development of side effects and blood cyclosporin (CyA) concentration in patients with psoriasis, based on the blood concentration monitoring data of CyA and the clinical chart. Sixty-five percent of 50 patients received CyA within the range of 3-5 mg/kg/day dose. Although the blood concentration rose as the dose increased, intra-individual variation of the blood concentration of CyA was extremely large. The blood CyA concentration in the patients evaluated as “fully effective” was within the range of 34-297 ng/ml, and that as “insufficiently effective” was 51-375 ng/ml. Based on the evaluation of the individual patients (n=9), the clinical effects were related to the blood CyA concentration in half of the patients. Hypertension (23%) as the side effect appeared with the highest frequency, followed by the reduction of renal function (12%).We found that hypertension developed frequently more over 100 ng/ml and renal function was reduced a more over 180 ng/ml.
In conclusion, It was shown that the blood CyA concentration should be monitored individually, since the optimum concentration for onset of effect was largely different among patients. Furthermore, it was demonstrated that we could advise doctors to ensurer the proper therapy through the blood CyA concentration monitoring in an attempt to avoid the onset of hypertension and renal failure which was dependent on the increasing blood CyA concentration.
