Cyclosporin A Treatment in Patients with Primary Biliary Cirrhosis

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Six patients with primary biliary cirrhosis (PBC) were treated with a relatively low dose of cyclosporin A for more than 6 months to determine whether cyclosporin A is beneficial to PBC. Serum levels of cyclosporin A were maintained at 50-100ng/ml during treatment in each patient. Serum levels of glutamate pyruvate transaminase, alkaline phosphatase and γ -glutamyl transpeptidase as well as serum levels of immunoglobulin M signisicantly decreased within 3 months following initiation of treatment, when compared with the pretreatment levels (p<0.05, p<0.01 p<0.05 and p<0.05, respectively). Histological changes in the liver before and after one year of treatment could be analysed in 2 of 6 patients, resulting in a marked reduction of infiltration of lymphocytes and OK-DR positive cells in the portal areas. However, cyclosporin A administration was discontinued within one year after initiation of treatment in 4 of 6 patients because of adverse effects such as hirsutism, renal dysfunction, impaired glucose tolerance, hypertension, leukopenia and anemia. These results suggest that a beneficial effect of cyclosporin A in the treatment of PBC may be limited, because even a relatively low dose of cyclosporin A causes its well-known side effects in PBC patients.
1992-12-25