Purpose: The authors evaluate whether monitoring of cyclosporine blood levels 6 hours after the morning dose (T6), as opposed to trough (T0), could reduce the incidence of side effects.
Methods: Cyclosporine dose adjustments were performed based on blood cyclosporine T6 enzyme-multiplied immunologic technique, irrespective of T0 and serum creatinine (SCr), in eight steroid- or azathioprine-resistant uveitis patients. The cyclosporine dose was adjusted to achieve a cyclosporine T6 level of 150 to 250 ng/ml.
Results: All patients improved clinically over 16 +/- 10 months. The mean dose of cyclosporine was 3.9 +/- 1.4 mg/kg/day. In 149 visits (47%), 70 dose adjustments were made. Initial and final SCr, potassium, magnesium, and uric acid serum levels and systolic/diastolic blood pressure measurements were not statistically different. There was no change in the creatinine clearance, glomerular filtration rate, or the effective renal plasma flow performed before starting T6 monitoring and at 13 +/- 8 months of follow-up.
Conclusions: Cyclosporine monitoring according to T6 levels is associated with optimal immunosuppression and stable renal function in patients with noninfectious uveitis.