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Inflammatory Bowel Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Cyclosporin should preferably not be initiated during pregnancy [53, 54]. It has not been found to be teratogenic in humans [65–67]. However, it is associated with SGA, preterm birth, hypertension and seizures [67, 68]. Breastfeeding is not recommended because of potential neonatal nephrotoxicity and immunosuppression [69].
Developments of Health Care: A Brief History of Medicine
Published in P. Mereena Luke, K. R. Dhanya, Didier Rouxel, Nandakumar Kalarikkal, Sabu Thomas, Advanced Studies in Experimental and Clinical Medicine, 2021
P. Mereena Luke, K. R. Dhanya, Tomy Muringayil Joseph, Józef T. Haponiuk, Didier Rouxel, S. Thomas
A South African surgeon, Dr. Christian Barnard (1922–2001) transplanted a human heart from one person into another’s body in 1967 at Cape Town. This first experience of clinical heart transplantation stimulated worldwide publicity and the procedure was rapidly co-opted by many surgeons. However, many patients died soon after the surgery, the number of cardiac transplants fell from 100 in 1968 to 18 in 1970 [79]. The main issue in the case of transplantation surgery was the normal tendency of the body to reject the new tissues. Significant developments in tissue typing and immunosuppressive drugs over the next 20 years have enabled more transplant procedures and enhanced recipient survival rates. In 1983, the Columbia University Medical Center launched clinical trials with cyclosporine-an immunosuppressive drugs originating from soil fungus (Discovered by Jean Borel in 1970) which was approved for commercial use (November 1983) and it is the most frequently prescribed immunosuppressant in organ transplantation [80]. When Cyclosporin was introduced as an immunosuppressive drug, many of the rejection problems were controlled. Advanced medical technology prevents organ rejection, has led to more efficient transplantation and increased demand.
Treatment of SJS and TEN
Published in Kirsti Kauppinen, Kristiina Alanko, Matti Hannuksela, Howard Maibach, Skin Reactions to Drugs, 2020
Cyclosporin has also been used in a few patients with a claimed benefit on the progression of the disease.27–29 In two of the four published observations, the disease recurred after withdrawal of cyclosporin, a very unusual event that could be interpreted as a rebound after a suspensive effect of cyclosporin.
Drug survival analysis of dupilumab and cyclosporin in patients with atopic dermatitis: a multicenter study
Published in Journal of Dermatological Treatment, 2022
Maddalena Napolitano, Maria Mariano, Antonio Cristaudo, Stefano Dastoli, Adriana Di Guida, Mario De Lucia, Gianluca Guerrasio, Steven Paul Nisticò, Maria Passante, Flavia Pigliacelli, Gabriella Fabbrocini, Cataldo Patruno
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a prevalence of about 2%–10% in the adult (1). Due to its chronicity, the choice of an effective and safe drug for long-term treatment is essential. In Italy, only cyclosporin and dupilumab are approved for the treatment of AD. Cyclosporin is a traditional immunosuppressive drug efficacious for treating AD, but its use is limited by several adverse event (2). Dupilumab is a monoclonal antibody blocking the effects of both of interleukin (IL)-4 and IL-13, pivotal cytokines in the pathogenesis of atopic diseases (3); it is proven to be effective and safe for long-term treatment of AD (4). For chronic conditions, such as AD, the efficacy and safety of a drug can be evaluated by drug survival (DS) analysis, besides clinical trials and real-life reports (5).
Immune thrombocytopenia
Published in Expert Review of Hematology, 2021
James Bussel, Nichola Cooper, Ralph Boccia, Francesco Zaja, Adrian Newland
There is little change in the 2019 ICR guidelines from the previous 2010 version regarding diagnosis – guidelines are expanded for the differential diagnosis of ITP and hepatitis B virus (HBV) infection, and bone marrow examination/biopsy is no longer necessary for diagnosis. In adult ITP, recent guidelines reflect increasing data with robust evidence available for TPO-RAs and fostamatinib, and recommend that splenectomy should be performed only after failure of medical (pharmacological) therapies. In pregnancy, cyclosporin A (CsA), TPO-RAs, and recombinant human (rh)-TPO (only available in China) are recommended and, in children, more aggressive treatment of newly diagnosed cases is recommended with early use of TPO-RAs for non-responders. Finally, there is a new QoL section for adults and children [23].
A review of published cases of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with the use of acetaminophen
Published in Cutaneous and Ocular Toxicology, 2021
Miloš N. Milosavljević, Ana V. Pejčić, Jovana Z. Milosavljević
The summary of treatment for each patient is given in Table 2. Use of some form of supportive and symptomatic care (e.g., local care, intravenous fluids, nutritional support, anti-infective medications, antihistamines, analgesics, mechanical ventilation…) was reported in 28 patients (77.8%). Systemic corticosteroids were reported to be administered in 25 (69.4%) patients and intravenous immunoglobulin (IVIG) in 16 (44.4%) patients (13 of these patients received both systemic corticosteroids and IVIG). Cyclosporin use was reported in 3 patients (8.3%). Plasmapheresis was performed in 3 patients (8.3%), while one patient (2.8%) underwent both total plasma exchange and continuous venovenous hemodiafiltration. Liver transplantation had to be performed in a patient with vanishing bile duct syndrome [22], patient with ileoileal intussusception underwent exploratory laparotomy with manual reduction of the intussusception [24], while one patient underwent unspecified surgical intervention [40]. Interleukin-2 receptor α (IL-2Rα) levels decreased significantly after treatment in six patients who used acetaminophen for viral infection [35].