Cyclosporine has been approved for use in allogeneic kidney, liver, and heart transplant patients and is under study for use in pancreas, bone marrow, single lung, and heart-lung transplant procedures. It is recommended that corticosteroids, such as prednisone, be used con-comitantly, although at half or less of their usual dose. Such combined therapy leads to fewer side effects, a decreased incidence of infectious complications, efficacy of lower doses of cyclosporine, and a better history of patient survival.
Cyclosporine appears to have promise in the treatment of autoimmune diseases. It has a beneficial effect on the course of rheumatoid arthritis, uveitis, insulin-dependent diabetes, systemic lupus erythematosus, and psoriatic arthropathies in some patients. Toxicity is more of a problem in these conditions than during use in transplantation, since higher doses of cyclosporine are often required to suppress autoimmune disorders.
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