Other substances

Cyclosporine

A cyclic peptide immunosuppressant.

Phase of research

Potential treatment - clinical evidence

How it helps

Other treatment

Drug status

Used to treat other disease

Supporting references

Contradictory references

AI-suggested references

Clinical trials

General information

Cyclosporine is a cyclic non-ribosomal peptide immunosuppressant. It is used in organ transplant patients and patients with various inflammatory conditions (ChEBI).

Cyclosporine on DrugBank
Cyclosporine on PubChem
Cyclosporine on Wikipedia

Synonyms

Cyclosporin A; Cyclosporine A; Ciclosporin

Marketed as

AQUA-STASIS; CEQUA; CYCLO-DERM; CYCLOSPORINE; GENGRAF; HYDRO-STASIS; NEORAL; RESTASIS; SANDIMMUNE; SANGCYA; VERKAZIA

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Supporting references

Link	Tested on	Impact factor	Notes	Publication date
Discovering drugs to treat coronavirus disease 2019 (COVID-19).	in silico			Feb/22/2020
The Host Cell ViroCheckpoint: Identification and Pharmacologic Targeting of Novel Mechanistic Determinants of Coronavirus-Mediated Hijacked Cell States Preprint	in silico		one of the top drugs and compounds identified by ViroTreat	May/17/2020
Comparative analysis of antiviral efficacy of FDA-approved drugs against SARS-CoV-2 in human lung cells: Nafamostat is the most potent antiviral drug candidate Preprint	Calu-3 human airway epithelial cells		lower IC50 value in Calu-3 cells than VERO E6 cells	May/12/2020
Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine... IL-6 Small molecule Peptide Antibody Cohort study	Patients		Associated with a significant decrease in mortality. Sample size: 253 + 354 control. Dosage: <5 mg/kg/day for 7-10 days (up to 21 days in severe cases); total cumulative dose >300 mg.	Oct/15/2020
Cyclosporine A plus low‐dose steroid treatment in COVID‐19 improves clinical outcomes in patients with moderate to severe disease. A pilot study Small molecule Peptide Cohort study	Patients	6.87	The subgroups of severe COVID-19 patients and patients with progressing pneumonia treated with cyclosporine had significantly better outcome compared to control. Lower mortality was observed in the whole treated cohort but especially in moderate to severe patients. Sample size: 105 (cyclosporine with steroids) + 104 control (steroids). Dosage: 1-2 mg/kg daily in two doses for 7 days. Endpoint: Time to clinical improvement until hospital discharge or death (primary).	Dec/03/2020
Drug repurposing for COVID-19 using machine learning and mechanistic models of signal transduction circuits related to SARS-CoV-2 infection Protein factor Small molecule Antibody In silico	in silico (machine learning)	13.49	Considered by the authors to be among the most relevant drugs identified in a machine-learning algorithm-based screening of compounds which considers causal protein-protein interactions, known drug targets, and specific signalling circuits in <a href=	Dec/11/2020
Drug repurposing screens reveal cell-type-specific entry pathways and FDA-approved drugs active against SARS-Cov-2 Small molecule In vitro Screening	Huh7.5 cells; Calu-3 cells; primary normal human bronchial epithelial cells; iPSC-derived AT2 cells; SARS-CoV-2 strain USA WA1/2020	8.11	Inhibited SARS-CoV-2 replication in Huh7.5 cells and also in Calu-3 cells with an SI of >3.	Mar/23/2021

AI-suggested references

Link	Publication date
Transitioning From Immunosuppressants to Dupilumab in Pediatric Atopic Dermatitis.	May/12/2020
Drug interaction profile of TKI alectinib allows effective and safe treatment of ALK+ lung cancer in the kidney transplant recipient.	Sep/13/2021
Potential SARS-CoV-2 protease Mpro inhibitors: repurposing FDA-approved drugs.	Feb/09/2021
Simultaneous Inhibition of SARS-CoV-2 Entry Pathways by Cyclosporine.	Feb/19/2021
Cannabidiol Inhibits In Vitro Human Liver Microsomal Metabolism of Remdesivir: A Promising Adjuvant for COVID-19 Treatment.	Jun/16/2020
Phase 1 trial of cyclosporine for hospitalized patients with COVID-19.	Apr/30/2020
[Role of cyclophilin A during coronavirus replication and the antiviral activities of its inhibitors].	Oct/12/2021
Nature-derived hit, lead, and drug-like small molecules: Current status and future aspects against key target proteins of Coronaviruses.	Jul/08/2021
Comparison of the Immunogenicity of ChAdOx1 nCoV-19 Vaccine against the Wild-Type and Delta Variants in Kidney Transplant Recipients and Healthy Volunteers.	Jan/31/2022
The Potential Use of Cyclosporine Ultrafine Solution Pressurised Metered-Dose Inhaler in the Treatment of COVID-19 Patients.	Nov/24/2021
Pharmacological development of the potential adjuvant therapeutic agents against coronavirus disease 2019	Jun/23/2020
Glucocorticoids Induce Partial Remission of Focal Segmental Glomerulosclerosis but Not Interstitial Nephritis in COVID-19 Acute Kidney Injury in an APOL1 Low-Risk Genotype White Patient	Oct/08/2021
Should cyclosporine be useful in renal transplant recipients affected by SARS-CoV-2?	Mar/11/2021
Inhibition of SARS-CoV-2 Infection by the Cyclophilin Inhibitor Alisporivir (Debio 025)	Nov/18/2021
Cyclophilin A and CD147: novel therapeutic targets for the treatment of COVID-19.	Jul/16/2020
SARS-CoV-2 pandemic : Time to revive the cyclophilin inhibitor alisporivir	Apr/10/2020
Cleaning and disinfection in health care settings during the COVID-19 outbreak.	Sep/01/2020
Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial.	Aug/04/2021
Pure red cell aplasia accompanied by COVID-19 successfully treated using cyclosporine.	Oct/25/2021
Multiple Roles of SARS-CoV-2 N Protein Facilitated by Proteoform-Specific Interactions with RNA, Host Proteins, and Convalescent Antibodies.	Jun/15/2021
Cyclophilin Inhibitors Restrict Middle East Respiratory Syndrome Coronavirus Via Interferon lambda In Vitro And In Mice	Jun/12/2020
Cyclosporine A Inhibits Viral Infection and Release as Well as Cytokine Production in Lung Cells by Three SARS-CoV-2 Variants	Jan/05/2022
Multi-omics-based identification of SARS-CoV-2 infection biology and candidate drugs against COVID-19.	Oct/10/2020
In Silico Evaluation of Cyclophilin Inhibitors as Potential Treatment for SARS-CoV-2.	Apr/14/2021
Repurposing of cyclophilin A inhibitors as broad-spectrum antiviral agents	Apr/05/2021
Cyclosporin A: A Repurposable Drug in the Treatment of COVID-19?	May/23/2020
Remdesivir and Cyclosporine Synergistically Inhibit the Human Coronaviruses OC43 and SARS-CoV-2.	Aug/13/2021
Cyclosporine A plus low-dose steroid treatment in COVID-19 improves clinical outcomes in patients with moderate to severe disease. A pilot study	Feb/02/2021
Successful Induction of Specific Immunological Tolerance by Combined Kidney and Hematopoietic Stem Cell Transplantation in HLA-Identical Siblings	Oct/15/2021
Medicines for Malaria Venture COVID Box: a source for repurposing drugs with antifungal activity against human pathogenic fungi	Nov/08/2021
Antibody response to double SARS-CoV-2 mRNA vaccination in Japanese kidney transplant recipients	Feb/04/2021
A genome-wide CRISPR screen identifies interactors of the autophagy pathway as conserved coronavirus targets	Dec/28/2021
Identification of host transcriptome-guided repurposable drugs for SARS-CoV-1 infections and their validation with SARS-CoV-2 infections by using the integrated bioinformatics approaches	Apr/07/2022
Seroprevalence of SARS-CoV-2-specific antibodies and vaccination-related adverse events in systemic lupus erythematosus and rheumatoid arthritis	Mar/05/2022
Early clinical experience with nirmatrelvir/ritonavir for the treatment of COVID-19 in solid organ transplant recipients	Dec/03/2021
Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective obser	Oct/15/2020
SARS-CoV-2 infection enhances mitochondrial PTP complex activity to perturb cardiac energetics.	Jan/01/2022
Immunological Response Against SARS-COV-2 After BNT162b2 Vaccine Administration Is Impaired in Allogeneic but Not in Autologous Stem Cell Transplant Recipients	Sep/14/2021
In vitro evaluation of antiviral activity of single and combined repurposable drugs against SARS-CoV-2	Jul/15/2020

Clinical trials

ID	Title	Status	Phase	Start date	Completion date
NCT04540926	Cyclosporine A Plus Low-steroid Treatment in COVID-19 Pneumonia	Not yet recruiting	Phase 1\|Phase 2	Sep/01/2020	Sep/30/2020
Alternative id - 135.2020 Interventions - Drug: Cyclosporin A Study type - Interventional Study results - No Results Available Locations - Jose Luis Jl Galvez-Romero, Puebla, Mexico Study designs - Allocation: N/A\|Intervention Model: Sequential Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 200 Age - 18 Years and older (Adult, Older Adult) Outcome measures - Number of days to clinical improvement until hospital discharge or death.
NCT04492891	Cyclosporine For The Treatment Of COVID-19(+)	Recruiting	Phase 2	Nov/23/2020	Nov/23/2025
Alternative id - H-48163 Interventions - Drug: Cyclosporine\|Other: Standard of Care Treatment Study type - Interventional Study results - No Results Available Locations - Baylor College of Medicine, Houston, Texas, United States Study designs - Allocation: Randomized\|Intervention Model: Parallel Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 75 Age - 18 Years to 90 Years (Adult, Older Adult) Outcome measures - WHO COVID-19 clinical severity scale
NCT04488081	I-SPY COVID-19 TRIAL: An Adaptive Platform Trial for Critically Ill Patients	Recruiting	Phase 2	Jul/31/2020	Nov/01/2022
Alternative id - I-SPY-COVID Interventions - Drug: Remdesivir\|Drug: Pulmozyme\|Drug: IC14\|Drug: Celecoxib Famotidine\|Drug: Narsoplimab\|Drug: Aviptadil Acetate\|Drug: Cyclosporine Study type - Interventional Study results - No Results Available Locations - University of Alabama at Birmingham, Birmingham, Alabama, United States\|UC Davis Medical Center, Davis, California, United States\|Long Beach Memorial Medical Center, Long Beach, California, United States\|University of Southern California, Los Angeles, California, United States\|Hoag Memorial Hospital Presbyterian, Newport Beach, California, United States\|University of California San Francisco (UCSF), San Francisco, California, United States\|University of Colorado, Aurora, Colorado, United States\|Yale Cancer Center, New Haven, Connecticut, United States\|Georgetown University, Washington, District of Columbia, United States\|Emory University, Atlanta, Georgia, United States\|Northwestern University, Chicago, Illinois, United States\|University of Iowa, Iowa City, Iowa, United States\|Kalispell Regional Medical Center, Kalispell, Montana, United States\|Montefiore Medical Center, Bronx, New York, United States\|Columbia University Medical Center, New York, New York, United States\|Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, United States\|University of Pennsylvania (U Penn), Philadelphia, Pennsylvania, United States\|Main Line Health - Lankenau Medical Center, Wynnewood, Pennsylvania, United States\|Sanford Health, Sioux Falls, South Dakota, United States Study designs - Allocation: Randomized\|Intervention Model: Parallel Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 1500 Age - 18 Years and older (Adult, Older Adult) Outcome measures - Identify agents that will result in substantial improvements to the clinical condition of participants with COVID-19\|Improvement in disease severity\|Health care utilization\|Frequency of serious AEs\|Mortality
NCT04392531	Clinical Trial to Assess Efficacy of cYclosporine Plus Standard of Care in Hospitalized Patients With COVID19	Completed	Phase 4	Apr/16/2020	Mar/31/2021
Alternative id - FJD-COVID19-20-01 Interventions - Drug: Cyclosporine\|Drug: Standard treatment Study type - Interventional Study results - No Results Available Locations - Complejo Hospitalario Universitario La Coruña, La Coruña, Galicia, Spain\|Hospital Quiron La Coruña, La Coruña, Galicia, Spain\|Hospital Rey Juan Carlos, Mostoles, Madrid, Spain\|Hospital Infanta Elena, Valdemoro, Madrid, Spain\|Hospital General de Villalba, Villalba, Madrid, Spain\|Fundacion Jimenez Diaz, Madrid, Spain\|Clinica Universitaria de Navarra, Madrid, Spain Study designs - Allocation: Randomized\|Intervention Model: Parallel Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 111 Age - 18 Years to 75 Years (Adult, Older Adult) Outcome measures - Severity Category\|Mortality Rate\|Number of Days in hospital\|Number of days in ICU beds\|Fio2 Needs\|Adverse events rate\|Change in CRP\|Change in ferritin\|Change in LDH\|Change in CPK\|Change in D Dimer\|Change in IL-6\|Change in KL-6\|Change in Viral Load\|Change specific antibodies
NCT04412785	Cyclosporine in Patients With Moderate COVID-19	Completed	Phase 1	Jun/30/2020	Oct/25/2021
Alternative id - 842998 Interventions - Drug: Cyclosporine Study type - Interventional Study results - No Results Available Locations - University of Pennsylvania, Philadelphia, Pennsylvania, United States Study designs - Allocation: N/A\|Intervention Model: Single Group Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 11 Age - 18 Years and older (Adult, Older Adult) Outcome measures - Safety-oxygen, ICU transfer and ventilation\|Safety-changes in absolute lymphocyte count\|Safety-changes in creatinine clearance\|Safety-secondary bacterial infections\|Laboratory measurements of safety and antiviral efficacy related to COVID-19-SARS-CoV-2 by measuring the clearance of SARS-CoV-2 from respiratory secretions\|Laboratory measurements-D-dimer levels\|Laboratory measurements-ferritin\|Laboratory measurements- IL-6
NCT04979884	Safety and Effectiveness of Cyclosporin in the Management of COVID19 ARDS Patients in Alexandria University Hospital	Not yet recruiting	Phase 3	Aug/01/2021	Apr/01/2022
Alternative id - cyclosporine in COVID-19 Interventions - Drug: cyclosporine Study type - Interventional Study results - No Results Available Locations - Study designs - Allocation: Randomized\|Intervention Model: Parallel Assignment\|Masking: None (Open Label)\|Primary Purpose: Treatment Enrollment - 150 Age - 18 Years to 65 Years (Adult, Older Adult) Outcome measures - Percentage of subjects with a 6-point ordinal scale showing each severity level\|Duration of hospital admission\|Rate of decline OF Soluble interleukin-2 (IL-2) receptor alpha. (sCD25)\|Rate of decline OF interleukin-1\|Rate of decline OF interleukin-10(IL-10)\|Rate of decline OF Interleukin-6,( IL-6)\|Rate of decline OF Tumour necrosis factor α (TNFα)\|Time to 50% a decrease of ferritin levels compared to peak value during trial\|Lung imaging improvement time\|Time for non-invasive or invasive initial use\|Time to improvement in oxygenation\|Number of days safe from ventilators\|Number of days on mechanical ventilation\|Number of days in the intensive care unit after randomization\|Incidence of (Adverse Events) and Incidence of nosocomial bacterial or invasive fungal infection\|Mean change of SOFA score in ICU patients\|Mean improvement in Clinical Deterioration Changed Early Warning Score (MEWS) between 1, 15 days)\|rate of Mortality\|all-cause mortality will be measured.

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