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Q&A with Australian Health Practitioners
Is it worth using cyclosporin long term for eczema?
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What do you think about long term monitored use of immunosuppresant drug like cyclossporin in treating sever atopic eczema. It seems to me that after 3 years the effectiveness is reduced -
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Prof Rodney Sinclair
Dermatologist
Professor Sinclair is a Professor of Dermatology at the University of Melbourne and Director of Sinclair Dermatology. He is past-president of the Australasian Society for … View Profile
For some people cyclosporin is the only thing that works for their eczema. If that is the case for you then the options are limited, and as you say the effectiveness commonly decreases over time. This is a specialist treament and you will be under the care of a dermatologist. You should discuss options to enhance the treatment with your dermatolgist.
Rod Sinclair
Professor of Dermatology
Epworth HospitalReport this post
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Dr Liam Beiglari
Allergy Specialist & Immunologist
I am a clinical immunologist and allergist. I am experienced in the diagnosis and treatment of adult patients with allergic diseases, autoimmune conditions, those living … View Profile
Very interesting question! And it does look like this post may be quite old. In the last 5-10 years there has been substantial progress made in new therapeutics for the treatment of patients living with atopic dermatitis/eczema who have severe disease that is not responding to topical steroids and moisturizers. These therapies, including JAK inhibitors like Upatacitinib and biologic medications like Dupilumab, have been very effective. My first preference is to use Dupixent/Dupilumab because it is available on the PBS, can be given by the patient themself at home and has a very good safety profile. The main risk with dupilumab are development of conjunctivitis which typically is mild to moderate and can be managed while the patient continues to receive benefit from this therapy. Many people (patients and referrers!) ask the question of whether it is possible to come off dupilumab once you have achieved good control. The tldr of this is that we need more data but at this stage it does look like stopping suddenly leads to relapse of the disease. Fortunately, control can be reachieved in most cases by restarting the treatment. So, for my practice I am comfortable with working together with patients to taper off the medication and seeing what their skin does off treatment with close supervision.
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