Cyclosporine in cats

Final report, Winn grant W09-028
Pharmacokinetics of cyclosporine after intravenous and subcutaneous administration in cats
Investigators: Sandra Diaz, David Panciera, James Meldrum; Virginia_Maryland Regional College of Veterinary Medicine

Cyclosporine A (CsA) is an immune-modulating drug that has traditionally been used for kidney transplantation in cats. In recent years, CsA has been reported to be effective in the management of several skin diseases, including allergic skin disease. CsA is typically given by mouth, but absorption of the drug is variable and not all owners can give oral medication to their cats long term. The objective of this study was to determine if subcutaneous administration of CsA would give predictable blood concentrations of the drug. If so, this route of drug administration could be easier for some cat owners, and may reduce side effects and reduce the need for blood monitoring of drug levels.

This study looked at the pharmacokinetic profile of CsA after intravenous (IV) and subcutaneous (SQ) administration. Five healthy adult cats were given a single IV bolus of CsA. After two weeks, they received a dose of CsA SQ every 48 hours for 14 days. Blood samples were taken and measured. No adverse effects were observed in any cat. The results indicated that SQ CsA bioavailability is very good. The SQ route could represent a promising route of administration in cats in the future. [VT]

See also: Heinrich NA, McKeever PJ and Eisenschenk MC. Adverse events in 50 cats with allergic dermatitis receiving ciclosporin. Vet Dermatol. 2011; 22: 511-20.

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Final report, Winn grant W09-028
Pharmacokinetics of cyclosporine after intravenous and subcutaneous administration in cats
Investigators: Sandra Diaz, David Panciera, James Meldrum; Virginia_Maryland Regional College of Veterinary Medicine

Cyclosporine A (CsA) is an immune-modulating drug that has traditionally been used for kidney transplantation in cats. In recent years, CsA has been reported to be effective in the management of several skin diseases, including allergic skin disease. CsA is typically given by mouth, but absorption of the drug is variable and not all owners can give oral medication to their cats long term. The objective of this study was to determine if subcutaneous administration of CsA would give predictable blood concentrations of the drug. If so, this route of drug administration could be easier for some cat owners, and may reduce side effects and reduce the need for blood monitoring of drug levels.

This study looked at the pharmacokinetic profile of CsA after intravenous (IV) and subcutaneous (SQ) administration. Five healthy adult cats were given a single IV bolus of CsA. After two weeks, they received a dose of CsA SQ every 48 hours for 14 days. Blood samples were taken and measured. No adverse effects were observed in any cat. The results indicated that SQ CsA bioavailability is very good. The SQ route could represent a promising route of administration in cats in the future. [VT]

See also: Heinrich NA, McKeever PJ and Eisenschenk MC. Adverse events in 50 cats with allergic dermatitis receiving ciclosporin. Vet Dermatol. 2011; 22: 511-20.

More on cat health: Winn Feline Foundation Library
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Cyclosporine in Cats

Katayama M, Katayama R, Kamishina H: Effects of multiple oral dosing of itraconazole on the pharmacokinetics of cyclosporine in cats, Journal of Feline Medicine & Surgery 12:512, 2010.

Renal transplantation has been considered as one possible therapeutic option for cats with end stage kidney failure. Cyclosporine (CsA) has been used as a core immunosuppressive drug in preventing acute allograft rejection in cats. Three male cats were studied to see if the co-administration of itraconazole (Icz) with CsA resulted in significant increases of oral availability of CsA. It was found that the use of itraconazole reduces the dosage required as well as the administration frequency of cyclosporine (from twice daily to once daily). [VT]

Related articles:
Schmiedt CW, Grimes JA, Holzman G et al: Incidence and risk factors for development of malignant neoplasia after feline renal transplantation and cyclosporine-based immunosuppression, Vet Comp Oncol 7:45, 2009.

More on cat health: Winn Feline Foundation Library
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Katayama M, Katayama R, Kamishina H: Effects of multiple oral dosing of itraconazole on the pharmacokinetics of cyclosporine in cats, Journal of Feline Medicine & Surgery 12:512, 2010.

Renal transplantation has been considered as one possible therapeutic option for cats with end stage kidney failure. Cyclosporine (CsA) has been used as a core immunosuppressive drug in preventing acute allograft rejection in cats. Three male cats were studied to see if the co-administration of itraconazole (Icz) with CsA resulted in significant increases of oral availability of CsA. It was found that the use of itraconazole reduces the dosage required as well as the administration frequency of cyclosporine (from twice daily to once daily). [VT]

Related articles:
Schmiedt CW, Grimes JA, Holzman G et al: Incidence and risk factors for development of malignant neoplasia after feline renal transplantation and cyclosporine-based immunosuppression, Vet Comp Oncol 7:45, 2009.

More on cat health: Winn Feline Foundation Library
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Feline Eosinophilic Keratitis

Spiess, A. K., J. S. Sapienza, et al. (2009). "Treatment of proliferative feline eosinophilic keratitis with topical 1.5% cyclosporine: 35 cases." Vet Ophthalmol 12(2): 132-7.

Eosinophilic keratitis is a progressive corneal disease seen in cats of any age. While the etiology is unknown, an immune-mediated response to feline herpesvirus is a suspected cause. The disease is unilateral in up to 75% of cases. The lesions are typically raised, irregular, white to pink masses. Scrapings of the lesions contain eosinophils, mast cells, and mixed inflammatory cells. Treatment is with topical corticosteroids, although some cases become refractory. Relapse is common if treatment is discontinued. The purpose of this study was to evaluate the efficacy of topical cyclosporine for feline eosinophilic keratitis. The disease was diagnosed by clinical appearance and corneal cytology in 35 cats. The mean age of affected cats was 6 years. Topical cyclosporine was administered either two or three times daily. The minimum follow up period was 5 months. Improvement was seen in 89% of cats. Recurrence was seen in 23% of cases. The researchers conclude that topical cyclosporine is an effective treatment for the majority of cats with eosinophilic keratitis, and that chronic, often life-long therapy is recommended. [SL]
>> PubMed Abstract

Related articles:
Andrew, S. E. (2008). "Immune-mediated canine and feline keratitis." The Veterinary clinics of North America. Small animal practice 38(2): 269-290.
>> PubMed Abstract

Moore, P. A. (2005). "Feline corneal disease." Clin Tech Small Anim Pract 20(2): 83-93.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Spiess, A. K., J. S. Sapienza, et al. (2009). "Treatment of proliferative feline eosinophilic keratitis with topical 1.5% cyclosporine: 35 cases." Vet Ophthalmol 12(2): 132-7.

Eosinophilic keratitis is a progressive corneal disease seen in cats of any age. While the etiology is unknown, an immune-mediated response to feline herpesvirus is a suspected cause. The disease is unilateral in up to 75% of cases. The lesions are typically raised, irregular, white to pink masses. Scrapings of the lesions contain eosinophils, mast cells, and mixed inflammatory cells. Treatment is with topical corticosteroids, although some cases become refractory. Relapse is common if treatment is discontinued. The purpose of this study was to evaluate the efficacy of topical cyclosporine for feline eosinophilic keratitis. The disease was diagnosed by clinical appearance and corneal cytology in 35 cats. The mean age of affected cats was 6 years. Topical cyclosporine was administered either two or three times daily. The minimum follow up period was 5 months. Improvement was seen in 89% of cats. Recurrence was seen in 23% of cases. The researchers conclude that topical cyclosporine is an effective treatment for the majority of cats with eosinophilic keratitis, and that chronic, often life-long therapy is recommended. [SL]
>> PubMed Abstract

Related articles:
Andrew, S. E. (2008). "Immune-mediated canine and feline keratitis." The Veterinary clinics of North America. Small animal practice 38(2): 269-290.
>> PubMed Abstract

Moore, P. A. (2005). "Feline corneal disease." Clin Tech Small Anim Pract 20(2): 83-93.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Read More

Cyclosporine for Cats with Dermatitis

Wisselink, M. A. and T. Willemse (2008). "The efficacy of cyclosporine A in cats with presumed atopic dermatitis: A double blind, randomised prednisolone-controlled study." Vet J. Feb 20 [epub]

Most cats with atopic dermatitis are treated with corticosteroids, but there are cases where it would be desirable to avoid this class of drugs due to adverse effects. Cyclosporine is widely used in human and veterinary medicine to treat immunological diseases. In most countries, it is licensed for use in dogs, but not cats. In feline dermatology, cyclosporine has been used to treat eosinophilic granuloma complex, pemphigus, atopic dermatitis, and other disorders. In this randomized, controlled, double-blind study, 29 cats with atopic dermatitis were divided into 2 groups. One group (11 cats) was treated with prednisolone (1 mg/kg daily) while the remaining cats were treated with cyclosporine (5 mg/kg/day) for 4 weeks. Blood samples for serum chemistries and hematology were collected at day 0 and day 28. During the trial, the owners were asked to evaluate the intensity of the pruritus once weekly on a linear analog scale and to record side effects. There was no significant difference between the 2 groups in the amount of remission or the number of cats that improved by >25%. No serious side effects were noted. The authors conclude that cyclosporine is an effective alternative to prednisolone for cats with atopic dermatitis.
>> PubMed Abstract

Related articles:
Noli, C. and F. Scarampella (2006). "Prospective open pilot study on the use of ciclosporin for feline allergic skin disease." J Small Anim Pract 47(8): 434-8.
>> PubMed Abstract

Vercelli, A., G. Raviri, et al. (2006). "The use of oral cyclosporin to treat feline dermatoses: a retrospective analysis of 23 cases." Vet Dermatol 17(3): 201-6.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Wisselink, M. A. and T. Willemse (2008). "The efficacy of cyclosporine A in cats with presumed atopic dermatitis: A double blind, randomised prednisolone-controlled study." Vet J. Feb 20 [epub]

Most cats with atopic dermatitis are treated with corticosteroids, but there are cases where it would be desirable to avoid this class of drugs due to adverse effects. Cyclosporine is widely used in human and veterinary medicine to treat immunological diseases. In most countries, it is licensed for use in dogs, but not cats. In feline dermatology, cyclosporine has been used to treat eosinophilic granuloma complex, pemphigus, atopic dermatitis, and other disorders. In this randomized, controlled, double-blind study, 29 cats with atopic dermatitis were divided into 2 groups. One group (11 cats) was treated with prednisolone (1 mg/kg daily) while the remaining cats were treated with cyclosporine (5 mg/kg/day) for 4 weeks. Blood samples for serum chemistries and hematology were collected at day 0 and day 28. During the trial, the owners were asked to evaluate the intensity of the pruritus once weekly on a linear analog scale and to record side effects. There was no significant difference between the 2 groups in the amount of remission or the number of cats that improved by >25%. No serious side effects were noted. The authors conclude that cyclosporine is an effective alternative to prednisolone for cats with atopic dermatitis.
>> PubMed Abstract

Related articles:
Noli, C. and F. Scarampella (2006). "Prospective open pilot study on the use of ciclosporin for feline allergic skin disease." J Small Anim Pract 47(8): 434-8.
>> PubMed Abstract

Vercelli, A., G. Raviri, et al. (2006). "The use of oral cyclosporin to treat feline dermatoses: a retrospective analysis of 23 cases." Vet Dermatol 17(3): 201-6.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Read More