Gingival hyperplasia associated cyclosporine

RE: Gingival hyperplasia associated cyclosporine

Julie Innes — Mon, 29 Apr 2019 08:56:02 GMT

I've now seen this in 2 patients on cyclosporine, it has actually put me off using it. Had to stop the drug in one and massively reduce the dose in the other.

RE: Gingival hyperplasia associated cyclosporine

Rachel Perry — Sun, 28 Apr 2019 22:04:06 GMT

The gingival hyperplasia will continue as long as the drug continues. Resection is an option but it will return unless the drug can be reduced sufficiently to stopped. There are reports of using azithromycin (not to be confused with azothioprine) to reverse it, but no personal experience.

RE: Gingival hyperplasia associated cyclosporine

Evelyn Barbour-Hill — Sun, 28 Apr 2019 21:56:46 GMT

I'd be glad to hear, if the company have any sensible suggestions.

RE: Gingival hyperplasia associated cyclosporine

Noirin Ni Shimidh — Sun, 28 Apr 2019 21:52:12 GMT

Thanks

I will ring the company and see how successful we can be with oral hygiene in this boisterous Labrador .

I‘m as sure as I can be that the cyclosporine is responsible, he is young, showed no sign of it before treatment and not a breed I’d expect it in but you never know...I really don’t want to withdraw the cyclosporine so I’d love to be wrong.

RE: Gingival hyperplasia associated cyclosporine

Evelyn Barbour-Hill — Thu, 25 Apr 2019 13:57:28 GMT

It's a knotty one.

I fear the only real answer to the hyperplasia that I know of (ready as ever to be corrected) would be to cease the cyclosporine. If that's not possible, you'll have to compromise.

Periodic resection would be acceptable. And don't forget oral hygiene in between, as the hyperplastic masses will be plaque traps.

Oh, and don't take this the wrong way, are you sure the hyperplasia has been caused by the cyclosporine?

RE: Gingival hyperplasia associated cyclosporine

Virginia Campbell — Thu, 25 Apr 2019 01:40:13 GMT

Also, I would try adding azathioprine for cyclosporin-sparing effect if possible (after discussion about risks and consent form for unlicensed drug). I haven't used it loads but have had good luck with it as an adjunct in a couple of immune mediated cases and no pancreatitis (though very small numbers).

RE: Gingival hyperplasia associated cyclosporine

Virginia Campbell — Thu, 25 Apr 2019 01:32:48 GMT

I've only seen this once, (in a Westie before Apoquel and Cytopoint existed)

Resected it twice but I think in his case it took nearly a year to get to the point of needing resected each time. Don't know what happened long term with him (moved jobs).

Give the drug company a ring...you won't be the first person to ask and they may have collated some info.