Ciclosporin Duration — SCE Dermatology MCQ
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Correct answer: D — 1-2 years maximum (with close monitoring of renal function) — beyond this, cumulative nephrotoxicity risk is unacceptable
BAD guidelines recommend Ciclosporin for psoriasis should be used for a maximum of 1-2 years continuously. Beyond this, the risk of irreversible cumulative nephrotoxicity (chronic Ciclosporin nephropathy — interstitial fibrosis and arteriolar hyalinosis) becomes unacceptable. Renal function must be monitored every 2 weeks initially then monthly (creatinine must not rise >30% above baseline). After 1-2 years, transition to alternative systemic therapy (Methotrexate, Acitretin, or biologics) is recommended. Short intermittent courses (3-6 months with drug-free intervals) may be used to extend the usable duration while reducing cumulative renal exposure. Ciclosporin should not be combined with phototherapy (increased skin cancer risk).
Reference: BAD 2020 Psoriasis; BNF