Cyclosporin Administration in the Treatment of Systemic Lupus Erythematosus andin Particular Lupus Nephritis

Overview

So far not very freguent therapeutic attempts, mostly without control groups, in severe cases of SLEwhich did not respond to previous standard treatment with cytostatic immunosuppressive prepa-rations revealed that small doses of cyclosporin combined with steroids (and occasionally combinedwith other immunosuppressive drugs) may lead to long-term improvement or remission of thedisease, incl. the reduction in dose of corticosteroids. Particularly significant clinical effects wereobserved when cyclosporin was administered along with steroids to patients with severe lupusnephritis. Focused on this problem the author mentions 13 hitherto available published studies(1989–98) on the treatment of lupus nephritis with cyclosporin. In these clinical trials improvementis reported – remission of the renal disease in 60–100 % of the treated patients. From this ensues thatit is useful to administer this drug to patients with serious forms of SLE, in particular with renalinvolvement who do not respond to the usual treatment or develop toxic manifestations after thistreatment. Nevertheless, whenever the doctor is to decide on the use of cyclosporin in these patients,he must assume in addition to the potential favourable effect in individual cases also a possible toxiceffect on the kidneys, in particular if the drug is administered for more than two years. Thus furthercontrolled and randomized studies are essential to obtain final information.

Key words:
cyclosporin, SLE, treatment