Cyclosporine quick and reliable treatment for atopic dermatitis in kids
"Cyclosporine works quickly and is very reliable. In my experience, more than 90% of patients will see a significant improvement, but there are real risks, including hypertension, kidney damage, monthly blood work, tremor, hypertrichosis, gum hypertrophy, and cancer/infection risk," Dr. Lio said at the annual meeting of the Society for Pediatric Dermatology.
To mitigate those risks he prescribes cyclosporine at a dose of 5 mg/kg per day with a cap of 300 mg per day to "to cool things down for 3-6 months. Then patients are transitioned to phototherapy or mycophenolate right away. "Methotrexate can also be used, but I rarely use azathioprine," he said.
While patients are on cyclosporine, blood pressure should be monitored each week for 4 weeks, and then monthly, he said. Draws for complete blood count, liver function tests, comprehensive metabolic panel, uric acid, and lipids should be performed monthly for 3 months, then every 8 weeks, he advised. Dr. Lio typically maintains the cyclosporine for 3 months, then tapers patients off the drug.