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Evaluation of cyclosporine for the treatment of DRESS syndrome

JAMA Jun 15, 2020

Nguyen E, Yanes D, Imadojemu S, et al. - As cyclosporine represents an alternative treatment for drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, researchers sought to ascertain its utility. DRESS syndrome is a potentially life-threatening hypersensitivity reaction; its features comprise skin eruption, fever, hematologic abnormalities, and multiorgan involvement. This condition may be fatal, with a mortality rate of up to 10%, if unrecognized. Discontinuation of treatment with the culprit drug, supportive care, and in severe eruptions with end-organ dysfunction, systemic immunosuppression with glucocorticoids are undertaken for maning this condition. However, treatment with cyclosporine, a calcineurin inhibitor with anti-apoptotic effects on cytotoxic T cells, may benefit patients with contraindications to glucocorticoids. In adition, cyclosporine limits production of interleukin-5, which generates eosinophilia and drug-specific T cells that mediate DRESS.

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