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ciclosporin (Gengraf / ciclosporin, AbbVie)

✓ Approved

AbbVie, Inc. · PPIA · Small Molecule

What is ciclosporin?

ciclosporin is a small molecule developed by AbbVie, Inc.. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesGengraf, ciclosporin, AbbVie
CompanyAbbVie, Inc.
Drug ClassSmall Molecule
Molecular TargetPPIA
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, AbbVie, Inc.

Mechanism of Action

Molecular Targets

ciclosporin acts on 1 molecular target:

PPIApeptidylprolyl isomerase A (HEL-S-69p, CYPH)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

ciclosporin is developed for 3 unique indications across 3 therapeutic areas.

Therapeutic AreaConditionPhase
Skin and subcutaneous tissue disordersPsoriasis✓ Approved
Musculoskeletal and connective tissue disordersRheumatoid arthritis✓ Approved
Immune system disordersSolid organ transplant rejection✓ Approved

Related Research Articles

PubMedCase reports in nephrology2026-08-18

Relapse of Steroid-Dependent Nephrotic Syndrome Despite Long-Term Ciclosporin Therapy in an 11-Year-Old Child: A Case Report and Review on the Management of Nephrotic Syndrome in Children.

Zaihan Abdullah Faiz AF, Jamil Nurdiana N, Kow Chia Siang CS

Frequently relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS) are distinct phenotypes defined by relapse frequency and the temporal relationship of relapse to prednisolone therapy, respectively. Both remain therapeutic challenges despite the use of corticosteroid-sparing agents. Relapses may be triggered by intercurrent infections and can be complicated by significant edema, hypoalbuminemia, and infection risk, requiring prompt optimization of immunosuppressive and supportive therapy. An 11-year-old boy with SDNS presented with a two-day history of bilateral periorbital swelling and facial puffiness following fever, rhinorrhea, and productive cough. He had experienced 11 previous relapses and was receiving ciclosporin 50 mg twice daily and enalapril 5 mg once daily with good adherence. Previous kidney biopsy showed minor glomerular change, and ciclosporin trough concentration was therapeutic. On admission, he was febrile (38.3°C) with leukocytosis, neutrophilia, thrombocytosis, marked hypoalbuminemia, significant proteinuria, and hematuria. Penicillin V was initiated for spontaneous bacterial peritonitis prophylaxis. Prednisolone was optimized from 40 mg once daily to 30 mg twice daily based on a body surface area of 1.17 m2. Progressive edema and weight gain required escalation to intravenous frusemide with 20% human albumin, resulting in marked clinical improvement. Proteinuria, hematuria, and ascites resolved, and he was discharged clinically stable with minimal residual edema. This case highlights several important therapeutic considerations in relapsing childhood nephrotic syndrome: recognition of SDNS as a subgroup of SSNS, accurate prednisolone dosing during relapse, careful assessment of edema and intravascular volume status before diuretic therapy, and individualized use of steroid-sparing agents and antimicrobial prophylaxis. In children receiving prolonged ciclosporin therapy, treatment should be regularly reviewed with blood pressure, renal function, and therapeutic drug monitoring in view of potential calcineurin inhibitor toxicity, and alternative steroid-sparing options such as levamisole may be considered where clinically appropriate.

PMID 42609695
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PubMedVeterinary dermatology2026-08-06

Symmetrical Lupoid Onychodystrophy in Review: Lessons Learned From 31 Cases.

Calesso Jessica R JR, Souza Clarissa P CP, Bruner Stephanie R SR, Bicalho Adriane P C V APCV

Symmetrical lupoid onychodystrophy (SLO) is a complex disease that exclusively affects the claws of dogs and represents a therapeutic challenge. Biopsy sampling of the third phalanx for histopathological evaluation has historically been the recommended diagnostic test, yet clinical diagnosis is currently encouraged. Numerous treatment protocols of varying success have been proposed for dogs with this condition. The goals of this study are to report clinical findings, treatment protocols and outcomes of dogs with SLO, to propose a rationale for the clinical diagnosis and to discuss therapies for SLO. Thirty-one dogs examined at a veterinary hospital from May 2004 to April 2024. Retrospective analysis of medical records from dogs diagnosed with SLO. The average age of dogs at disease onset and diagnosis was 7 years old. Nineteen breeds were represented. Thirty dogs were clinically diagnosed with SLO, mostly presenting with onychodystrophy and onychomadesis, and in one a biopsy sample was collected. Different therapeutic combinations including tetracyclines alone or with niacinamide, pentoxifylline, essential fatty acids (EFAs), vitamin E, biotin and ciclosporin were used for the initial and/or maintenance treatment of SLO. The distinctive presentation of SLO supports its clinical diagnosis. Medical treatment seems to support a favourable long-term outcome, despite the wide variation in protocols and doses. EFAs were commonly used as initial and maintenance therapy, and tetracyclines could often be excluded from the treatment protocol, thus complying with good antimicrobial stewardship practice.

PMID 42559714
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PubMedFrontiers in medicine2026-07-30

Case report: Three contrasting presentations of acute oesophageal necrosis and the determinants of outcome.

Loo Guo Hou GH, Kosai Nik Aisyah NA, Villareal Val Michael VM, Muthukumaran Guhan G et al.

Acute oesophageal necrosis (AEN), or "black oesophagus," is a rare but potentially lethal cause of upper gastrointestinal bleeding (UGIB), classically described in elderly men with cardiovascular comorbidity. Contemporary reports emphasize a broader clinical spectrum encompassing younger immunosuppressed and critically ill patients. We describe three patients managed at a single tertiary Malaysian center. Case 1: a 77-year-old man with type 2 diabetes and stage 3b chronic kidney disease, not on anticoagulation, presented with coffee-ground vomitus; endoscopy revealed circumferential blackish necrosis of the distal two-thirds of the oesophagus; he was treated with submucosal adrenaline injection and supportive care and achieved complete mucosal healing at 6 weeks. Case 2: a 52-year-old woman with relapsed focal segmental glomerulosclerosis on prednisolone and ciclosporin, complicated by methicillin-sensitive Staphylococcus aureus bacteraemia, hospital-acquired pneumonia, and respiratory failure requiring intubation. On the eighth day of admission she developed haematemesis with blood-stained oropharyngeal secretions, prompting emergency bedside oesophagogastroduodenoscopy; this demonstrated severe AEN with extensive submucosal tear, intramural haematoma, and multifocal necrosis, managed conservatively with nasojejunal feeding and high-dose proton pump inhibitor, with full mucosal recovery by 76 days. Case 3: a 49-year-old woman with end-stage renal failure on continuous ambulatory peritoneal dialysis (CAPD) for 6 years, admitted with relapsing Acinetobacter baumannii peritonitis, complicated by hospital-acquired carbapenemase-producing Klebsiella pneumoniae peritonitis. Her Tenckhoff catheter was removed early and she was converted to haemodialysis; she met Sepsis-3 criteria and required intensive care. On day 49 she developed UGIB; eight sequential endoscopies demonstrated a large oesophageal clot, extensive sloughy necrotic mucosa with longitudinal ulceration, and recurrent haemorrhage requiring multimodal endoscopic hemostasis (endoclips, adrenaline, hemoblock, hemospray, tranexamic acid), with ultimate mucosal healing. Despite this, she died on day 91 from septic shock attributed to a refractory intra-abdominal infection and catheter-related candidaemia; an indirect contribution from her complicated oesophageal course cannot be excluded. These three contrasting cases illustrate the heterogeneity of AEN and reinforce the contemporary teaching that long-term outcome is determined principally by the underlying systemic illness. AEN should be considered in any acutely unwell patient with UGIB regardless of demographic profile, including immunosuppressed and long-term dialysis recipients.

PMID 42528813
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PubMedCureus2026-07-24

Wiskott-Aldrich Syndrome With Severe Thrombocytopenia and Hemorrhagic Manifestations: A Case Report.

Cherrabi Chaymae C, Tkak Hassnae H, Bellaoui Mohamed M, Ghanam Ayad A et al.

Wiskott-Aldrich syndrome (WAS) is a rare X-linked primary immunodeficiency characterized by the association of thrombocytopenia with microplatelets, eczema, and immune dysfunction, with a highly variable clinical presentation that may include severe hemorrhagic and infectious manifestations in early childhood. We report the case of an infant referred for evaluation of a hemorrhagic syndrome associated with eczema, in whom laboratory investigations revealed severe thrombocytopenia. The clinical course was complicated by a cerebral hemorrhage. The patient was managed with supportive measures, including intravenous immunoglobulin therapy and antibiotic prophylaxis. Despite treatment, thrombocytopenia persisted and required repeated platelet transfusions. Immunosuppressive therapy with corticosteroids and ciclosporin was introduced. This case highlights the importance of early recognition of WAS in infants presenting with thrombocytopenia and eczema, and emphasizes that management remains mainly supportive, while early evaluation for hematopoietic stem cell transplantation is essential to improve prognosis.

PMID 42495506
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PubMedBMJ case reports2026-07-23

Ocrelizumab-induced colitis acutely managed with ciclosporin.

Dimovski Stephanie S, Terlato Maddison M, Segal Jonathan P JP

Ocrelizumab is an anti-CD20 monoclonal antibody widely used in the treatment of multiple sclerosis (MS). Although rare, ocrelizumab-induced colitis is a recognised and potentially severe condition that may require life-saving surgical intervention if left untreated. Accurate diagnosis requires the exclusion of infective colitis or classical inflammatory bowel disease (IBD). Prolonged depletion of the CD20-positive B cell population by ocrelizumab may prolong the symptomatic trajectory and complicate the diagnosis. The lack of comprehensive data on ocrelizumab-induced colitis makes acute medical management of affected patients particularly challenging. This report details the case of a woman with steroid-refractory ocrelizumab-induced colitis, managed effectively with ciclosporin therapy in the salvage setting. Monitoring therapeutic drug levels, monitoring for neurotoxicity and early multidisciplinary team involvement facilitated safe titration of ciclosporin.

PMID 42486658
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PubMedBMJ case reports2026-07-21

Adult-onset Still's disease presenting with periorbital erythematous rash and progressive interstitial lung disease.

Oshima Tomoko T, Miwa Seiich S, Ito Yasuhiro Y, Shirai Masahiro M

A man in his 80s with chronic obstructive pulmonary disease presented with fever, arthralgia and periorbital erythema resembling a heliotrope rash, accompanied by progressive interstitial lung disease (ILD). Laboratory investigations revealed neutrophilic leucocytosis and markedly elevated C-reactive protein, ferritin and Krebs von den Lungen-6. Dermatomyositis, particularly clinically amyopathic dermatomyositis, was considered in the differential diagnosis; however, myositis-specific autoantibodies were negative and histopathological findings supported a diagnosis of adult-onset Still's disease (AOSD). Despite the high-dose corticosteroids and ciclosporin, lung disease progressed to respiratory failure. Treatment with tocilizumab led to clinical and radiological remission with normalisation of inflammatory markers.This case highlights that AOSD can present with rapidly progressive ILD and closely mimic dermatomyositis, underscoring the importance of careful differential diagnosis and timely cytokine-targeted therapy.

PMID 42476604
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