Efficacy and safety of once- versus twice-daily dosing of cyclosporin A for the treatment of nephrotic syndrome: A retrospective study

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  • Hirai Sayaka
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University
  • Matsumoto Takafumi
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University
  • Suzuki Kazuma
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University
  • Okutomi Yuya
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University
  • Shioiri Michiko
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University
  • Kondo Masami
    Department of Pharmacy Service, Saitama Medical Center, Saitama Medical University

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Other Title
  • ネフローゼ症候群に対するシクロスポリンの1日1回投与と1日2回投与の有効性と安全性に関する後方視的調査
  • ネフローゼ ショウコウグン ニ タイスル シクロスポリン ノ 1ニチ 1カイ トウヨ ト 1ニチ 2カイ トウヨ ノ ユウコウセイ ト アンゼンセイ ニ カンスル コウホウ シテキ チョウサ

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<p>Cyclosporin A (CyA) is often used to treat patients with steroid resistance and steroid dependence, which are indicative of recurrent-nephrotic syndrome. However, there are only a few detailed reports on the optimal dosing frequency of CyA. Therefore, in this study, we investigated the safety and efficacy of once- versus twice-daily dosing of CyA in patients with nephrotic syndrome.</p><p>Our study included patients who received CyA therapy from January 1, 2011, to September 30, 2017; had area under the plasma concentration-time curve values calculated for 0-4 hours; and continued CyA treatment for more than six months. Thirty-nine patients were included in this study (26 patients dosed once-daily; 13 patients dosed twice-daily). We used the change in the urine protein-to-creatinine ratio between six months after the initiation of CyA therapy as an effective index. At six months, the index was significantly lower in patients who were receiving once-daily dose than those receiving twice-daily CyA (75.19 ± 20.76 mg vs 103.85 ± 30.22 mg, P<0.01). Additionally, there was no significant difference in once-daily dosing and twice-daily dosing (69.2% vs. 53.8%, p=0.48). Notably, at 6 months, the laboratory data for both once- and twice-daily dosing were within the normal range.</p><p>Overall our results show that once-daily dosing of CyA is, at least as effective as twice-daily dosing. Importantly, once-daily dosing enhances patient compliance, expenditure, and ensures patient safety; therefore, our results encourage the use of once-daily dosing of CyA in clinics.</p>

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