Cyclosporine, Lessons Learned: Promising Successes and Abject Failures

This lecture will discuss successes and failures in the therapeutic application of cyclosporine in human and, especially, small animal medicine, based on both research and clinical data, with a focus on both historical perspectives and recent advances. Successful and unsuccessful applications that will be discussed include human, canine and feline transplant experiences, utility of both pharmacokinetic and pharmacodynamic therapeutic drug monitoring, experiences with various formulations and routes of administration (brand name, generic, compounded and transdermal), impact of inherited and acquired factors that affect drug metabolism, impact and management of problems associated with drug cost, topical uses such as treatment of keratoconjunctivitis sicca and atopic dermatitis, problems associated with secondary infections, and relatively recent successes with use for treatment of challenging diseases such as polyarthritis, inflammatory bowel disease and idiopathic canine hepatitis.