CYCLOSPORINE MONITORING WITH LEVELS 6 HOURS AFTER THE MORNING DOSE INPATIENTS WITH NONINFECTIOUS UVEITIS

Purpose: The authors evaluate whether monitoring of cyclosporine blood levels 6 hours after the morning dose (T6), as opposed to trough (TO) , could reduce the incidence of side effects. Methods: Cyclosporine do se adjustments were performed based on blood cyclosporine T6 enzyme-mu ltiplied immunologic technique, irrespective of TO and serum creatinin e (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 1 6 +/- 10 months, The mean dose of cyclosporine was 3.9 +/- 1.4 mg/kg/d ay, In 149 visits (47%), 70 dose adjustments were made, Initial and fi nal SCr, potassium, magnesium, and uric acid serum levels and systolic /diastolic blood pressure measurements were not statistically differen t. There was no change in the creatinine clearance, glomerular filtrat ion rate, or the effective renal plasma flow performed before starting T6 monitoring and at 13 +/- 8 months of follow-up, Conclusions: Cyclo sporine monitoring according to T6 levels is associated with optimal i mmunosuppression and stable renal function in patients with noninfecti ous uveitis.