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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
FR.17.11 Impact of the Cyclosporin A absorption for an effective immunmodulatory therapy of patients with high-risk keratoplasty Bailly N., Dunewa I., Rieck P.
Department of Ophthalmology, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin Objective: Cyclosporin A (CsA) is applied as an immune modulator in transplantation medicine, amongst others high-risk keratoplasty. As drug monitoring e.g. after a kidney-transplantation the c0- and c2-serum levels are described. The intestinal absorption plays an important role for reaching the therapeutical drug level and for the development of side effects. We examined the c0- and for corneal transplantation not yet defined c2-serum levels. Furthermore, especially the rate of so called “non- or low-absorbers” was determined. It was examined to what extent a low-absorption is essential for a successful therapy.
Methods: The adjustment of the target drug level of CsA with patients after high-risk keratoplasty was prospective. The follow-up of the patient group (n=34) included 2 to 85 months postoperatively. The evaluation contained data about CsA dose rate, c0- and c2-serum levels (2h after oral CsA-application) and clinical follow-ups. Using statistical methods the rate of “non- or low-absorbers”, incidence of rejection under CsA-therapy and survival probability of the corneal grafts were investigated.
Results: A high intra- and interindividual variance of C0- und C2-values was observed in the examined group of patients (n=34). A rate of up to 23.5% represented “low-absorbers”. Side effects like gastrointestinal afflictions, blood pressure dysfunction, elevation of liver enzymes were found in 26.4%, thereof 55.5% were “low-absorbers”. Patients with a rheumatic condition were over represented among the “low-absorbers” (37.5%). The data for survival analysis and Log rank test will be completed after closing of the follow-up period to get comparable data for patient groups with and without CsA-therapy.
Conclusions: The C2-blood level is a helpful parameter to control the immune modulatory therapy with CsA to secure an optimal drug level. The “non- or low-absorbers” should be identified as early as possible to ensure a sufficient therapy.
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