RT Journal Article
SR Electronic
T1 Preservation of post-transplant lung function with aerosol cyclosporin
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 378
OP 383
DO 10.1183/09031936.04.00059204
VO 23
IS 3
A1 T.E. Corcoran
A1 G.C. Smaldone
A1 J.H. Dauber
A1 D.A. Smith
A1 K.R. McCurry
A1 G.J. Burckart
A1 A. Zeevi
A1 B.P. Griffith
A1 A.T. Iacono
YR 2004
UL http://erj.ersjournals.com/content/23/3/378.abstract
AB Post-lung transplant use of aerosol cyclosporin (ACsA) is considered by examining the relationship between deposited aerosol dose and effect. In a sub-study of placebo controlled trials of ACsA as a rejection prophylaxis, 15 drug subjects received aerosol dose quantification tests to gage their ability to effectively deposit the nebulised drug in their transplanted lung(s). A total of seven placebo subjects received mock deposition tests. The deposited doses and mock doses were compared to changes in the forced expiratory volume in one second, at six time points during the 2‐yr trial period (ACsA was started within 6 weeks post-transplant). Linear relationships were demonstrated between deposited dose and improvement in lung function in the drug subjects at all intervals. Mock dose data from placebo subjects did not demonstrate similar correlation. Based on these results, subjects were grouped by dose and compared. Subjects depositing ≥5 mg of the drug in the periphery of their transplant(s) had improving pulmonary function on average. Low-dose and placebo subjects demonstrated declines, more A2–A4 rejection events in the latter portion of the trial, and more chronic rejection beyond the end of the trial. A dose-to-effect relationship is demonstrated for aerosol cyclosporin in terms of pulmonary function and biopsy proven rejection. This research was supported by grants from the National Heart, Lung and Blood Institute, and the American Lung Association. The cyclosporin powder was provided by Novartis Pharmaceuticals.