피부질환 치료에서의 경구 사이클로스포린의 부작용에 대한 연구

Abstract

Background: Cyclosporine (CS) is being successfully used for various skin diseases including psoriasis, atopicdermatitis, and chronic idiopathic urticaria. However, dermatologists have hesitated to use CSs in clinical practicesdue to possible adverse effects. Objective: The aim of this study is to investigate the adverse effects of CS for dermatological uses. Methods: We performed a retrospective study by including 1,335 patients with CS treatment. Results: From 1,335 patients, 208 (15.6%) showed adverse effects and obvious laboratory changes. Twenty fivepatients experienced either two or more adverse effects. Gastrointestinal (GI) symptoms were the most common sideeffects. Other side effects included hypercholesterolemia (2.2%), hypertrichosis (2.2%), headache (1.3%), hypertension(0.9%), and hypertriglyceridemia (0.9%). Hypercholesterolemia is more frequently found in men but, GIsymptoms and hypertrichosis are more frequent in women. Hypercholesterolemia, hypertriglyceridemia, and GIsymptoms are more common in adults but hypertrichosis is more common in children and adolescents. Hypertension,hypercholesterolemia, and hypertriglyceridemia have been remarkable in psoriasis patients, and GI symptoms andhypertrichosis are found in patients with atopic dermatitis. GI symptoms and headaches occur more often withinthree months of the CS treatment; however, hypertension, hypercholesterolemia, and hypertriglyceridemia usuallyoccur three months after. With regards to CS dose, the hypertrichosis is more common in the group with low initialdose. GI symptoms occur more often in the lower CS cumulative dose group; however, hypertension and hypertriglyceridemiaare higher in the CS cumulative dose group. Conclusion: As compared with previous studies, the frequency of adverse effects after CS treatment in this studyis proved to be low. Therefore, under dermatological fields, we suggest that CS is a relatively safe drug withperiodic follow-ups and laboratory tests.