Study: Aerosol Cyclosporine Improves Lung Function After Transplant

Regular thrice-weekly therapy with an aerosol form of the immunosuppressive drug cyclosporine appears to improve the lung function of lung transplant patients, according to University of Pittsburgh Medical Center researchers.

Their results from a study of 15 patients are the first to emerge from a larger multi-year clinical trial looking at the effectiveness of aerosol cyclosporine spray, which is inhaled directly into the lungs, for the prevention of rejection in lung transplant patients.

In the study presented at the annual meeting of the International Society for Heart and Lung Transplantation, researchers said half of the single-lung and double-lung transplant patients studied received aerosol cyclosporine in addition to standard anti-rejection drugs that for the most part were tacrolimus.

The 30-minute treatments -- in which patients breathed the mist containing aerosolized cyclosporine in a mixture with propylene glycol -- began approximately six weeks after transplantation and took place three times a week for two years. The patients were then followed for an additional two years.

Patients who absorbed at least 5 mg of the drug in their transplanted lung showed significant improvement in lung function over time, whereas patients who absorbed less than 5 mg and patients who were given an aerosol spray containing a placebo demonstrated decline in lung function, the researchers said.

For instance, single-lung recipients who absorbed at least 5 mg of the drug showed a 15 percent improvement at 200 days and a 25 percent improvement in lung function by 600 days, the researchers reported. Patients who absorbed less of the drug or received placebo had a steady decline in lung function of up to 10 percent by day 600.

The researchers now are working to develop techniques that will enhance absorption of the aerosol cyclosporine so that all transplant patients can have maximum benefit from the treatment.

"This most recent analysis – our first from the 68-patient study – indicates that aerosol cyclosporine specifically enhances lung function in patients who deposit (absorb) higher concentrations of the drug," concluded Dr. Aldo T. IaconoIacono, director of pulmonary transplant medicine at the University of Pittsburgh.

Other Sources: University of Pittsburgh Medical Center