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  • Title: Cyclosporine A: good response for patients affected by autoimmune disorders and HCV infection?
    Author: Manna R, Verrecchia E, Fonnesu C, Giovinale M, De Socio G, Curigliano V, Cerquaglia C, Soriano A, Granata M, Migliore A, Massafra U, Gasbarrini G.
    Journal: Eur Rev Med Pharmacol Sci; 2009 Mar; 13 Suppl 1():63-9. PubMed ID: 19530514.
    Abstract:
    INTRODUCTION: In autoimmune disorders (ADs), if Hepatitis C Virus (HCV) is present, immunosuppressive treatment could increase virus replication. Cyclosporine A (CsA), in standard therapeutic doses, has been proven able to inhibit HCV cyclophilin in vitro. Therefore CsA could improve the therapy of HCV patients with ADs. AIM: In these patients, we started an open pilot study to evaluate the safety of 3 mg/kg CsA and the ability to reduce steroid therapy. PATIENTS AND METHODS: Five females and 1 male were recruited; mean age 66 +/- 8 years, mean disease duration 13 +/- 5 years. Three patients are affected by Psoriasic Arthritis, 1 by Rheumatoid Arthritis, 1 by Sjogren Syndrome, and 1 by Myasthenia Gravis. None of them had chronic active hepatitis. HCV genotypes were type 2 (in 3 cases) and type 1 (in 3 cases). Patients were treated with 3 mg/kg of CsA for a period of time ranging from 6 to 12 months. The starting mean dose of prednisone was 12.5 mg/day. Liver function tests were checked monthly and serum HCV-RNA load was checked by RT-PCR before and 2 months into the therapy. RESULTS: The prednisone dose was reduced from 12.5 mg/day to 7.5 mg/day. The aminotransferases levels were unchanged after 6 months. In patients with low HCV-RNA levels before treatment, no modifications of viral load were observed, whereas patients with increased levels at onset showed mild reduction 2 months into the treatment. CONCLUSIONS: Immunosuppressive treatment of ADs patients with HCV infection can be safely provided with the integration of CsA.
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