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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

PubMedArtificial organs2026-08-29

The Effects of Continuous Venovenous Hemofiltration on Immunosuppressive Drug concentrations in an Ex-Vivo Model of the critically Ill Adult: (CITRIC) study.

Chumas Lucy A LA, Wallis Steven C SC, Sumi Chandra C, Abdul-Aziz Mohd Hafiz MH et al.

The pharmacokinetics of immunosuppressive drugs during continuous kidney replacement therapy (CKRT) modalities such as continuous venovenous hemofiltration (CVVH) are poorly understood, yet these drugs are crucial for transplant and critically ill patients. An ex vivo adult CVVH circuit with AN69ST membrane was established, using whole blood (WB) or blood-crystalloid (BC) to simulate hypoproteinemia and anemia, across a range of ultrafiltration rates (UFR) (1000-4000 mL/h) and point-of-dilution. Study drugs (tacrolimus, ciclosporin, mycophenolic acid (MPA), hydrocortisone, and methylprednisolone) were administered at clinically relevant concentrations. Drug concentrations were quantified by ultra-high-performance liquid chromatography-tandem mass spectrometry, and sieving coefficient (Sc) and clearance (Cl) were calculated. Mean Sc and Cl were significantly higher for BC than WB: methylprednisolone (Sc: 0.44 vs. 0.19 p < 0.001; Cl: 17.31 mL/min vs. 6.99 mL/min p < 0.001), hydrocortisone (Sc: 0.20 vs. 0.09 p = 0.005; Cl: 7.12 mL/min vs. 3.15 mL/min p = 0.01), MPA (Sc: 0.05 vs. 0.02 p < 0.001; Cl: 1.83 mL/min vs. 0.71 mL/min p < 0.001), ciclosporin (Sc: 0.00 vs. 0.00 p = 0.008; Cl: 0.02 mL/min vs. 0.01 mL/min p = 0.004). Tacrolimus was undetectable in ultrafiltrate. Point-of-dilution had minimal effect, except at UFR 4000 mL/h where pre-dilution increased MPA and methylprednisolone clearance. Hydrocortisone and methylprednisolone were cleared by CVVH, while tacrolimus, ciclosporin, and MPA Cl were negligible or absent. Hypoproteinemia and anemia significantly increased drug Cl. These findings provide mechanistic insights and support the need for validation in clinical studies to guide dosing during CKRT.

PMID 42666083
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PubMedDermatology and therapy2026-08-28

Dual-Targeted Therapy in Refractory Pyoderma Gangrenosum: A Focused Systematic Review of Convergent Pathway Targeting.

Shanshal Mohammed M, Karanasios George G

Refractory pyoderma gangrenosum (PG) may persist despite corticosteroids, ciclosporin, biologics or sequential treatment escalation. Dual-targeted therapy (DTT) is increasingly used in medically complex inflammatory bowel disease (IBD), but PG is often recorded only as an extraintestinal manifestation. We examined the direction, extractability and attribution limits of PG outcomes reported during concurrent DTT. PubMed, Embase via Ovid and Web of Science Core Collection were searched from inception to 26 July 2026. Eligible reports described at least one patient with PG receiving concurrent systemic DTT, defined as biologic-biologic, biologic-Janus kinase (JAK) inhibitor or biologic-phosphodiesterase-4 inhibitor combinations. Screening and extraction were performed independently and in duplicate. The analytic unit was the PG exposure. Outcomes were retained as source-reported and were not pooled because PG assessment, follow-up and co-intervention reporting were non-standardised. Fourteen reports described 17 PG exposures. Of these, 14 had an extractable PG-specific cutaneous outcome, all source-reported using non-standardised assessments as improved or resolved. This 14-of-14 pattern reflects the direction of published outcome-bearing observations, not a denominator-based response estimate. Three additional cohort-level records documented PG exposure without a separable cutaneous end-point. A total of 16 exposures were IBD-associated and 11 involved JAK-containing regimens. Individual regimen mapping, diagnostic ascertainment, follow-up and co-intervention reporting were frequently incomplete. All evidence was uncontrolled, safety reporting was limited and the complete exposure denominator was unknown. Favourable PG outcomes were reported across several DTT pathway pairings, but these uncontrolled published observations do not establish efficacy, comparative advantage or added benefit from simultaneous pathway blockade. The next step is a dermatology-embedded prospective registry within IBD DTT programmes, with standardised PG diagnosis, lesion documentation, co-intervention recording and exposure-specific safety ascertainment. Until such evidence is available, DTT should remain an exceptional multidisciplinary consideration rather than an established PG treatment strategy.

PMID 42663862
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PubMedSurgical case reports2026-08-28

Simultaneous Liver-Kidney Transplantation from a Deceased Donor for Glycogen Storage Disease Type Ia: A Case Report.

Hirata Yuta Y, Sanada Yukihiro Y, Takadera Kiichiro K, Akimoto Ryosuke R et al.

Glycogen storage disease type Ia (GSD Ia) is an indication for simultaneous liver-kidney transplantation (SLKT) due to multiple hepatocellular adenomas and chronic renal failure. In this report, we describe a deceased-donor SLKT in a patient with GSD Ia who presented with hypoglycemic attacks, progressive multiple hepatocellular adenomas, and chronic renal failure. The patient was diagnosed with hepatomegaly at the age of 1 year and 6 months, with a diagnosis of GSD Ia, and was started on a special diet. She had been aware of liver tumors since 24 years of age. At 29 years of age, she underwent left lateral segmentectomy and radiofrequency ablation for multiple liver tumors. She began to suffer from renal dysfunction around 39 years of age, and then at 40 years of age, she was diagnosed with chronic renal failure and therefore was started on hemodialysis. She began having recurrent hypoglycemic attacks after the introduction of dialysis. Due to repeated hypoglycemic attacks, multiple hepatocellular adenomas, and chronic renal failure, she was deemed eligible for SLKT and thus was registered for deceased-donor SLKT at 41 years of age. She underwent SLKT at 46 years of age. The liver graft weight was 1060 g, and the graft-to-recipient body weight ratio was 2.41. The kidney graft weight was 170 g. The weight of the excised liver was 2710 g. Although no malignant findings were observed in the excised liver, multiple hepatocellular adenomas were identified. She was able to urinate independently immediately after the SLKT and was able to discontinue dialysis immediately afterward. Immunosuppressive therapy was initiated with basiliximab, ciclosporin A, methylprednisolone, and mycophenolate mofetil (MMF). However, due to abdominal pain and liver dysfunction caused by MMF, she was switched to mizoribine on POD 46, and her abdominal pain improved thereafter. She progressed well and was discharged on POD 49. Her liver and kidney functions remained good approximately 2 years after the SLKT. Adult patients with GSD Ia require transplantation due to hypoglycemic attacks, multiple liver tumors, and chronic renal failure.

PMID 42662052
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PubMedGenes2026-08-27

Integrated Transcriptomic and Machine-Learning Analyses Identify Shared Na+ Overload-Related Gene Signatures in Inflammatory Bowel Disease and Ankylosing Spondylitis.

Wu Luojin L, Ou Chenghao C, Liu Xuan X, Yan Miaohan M et al.

Background: Ankylosing Spondylitis (AS) and inflammatory bowel disease (IBD) exhibit substantial pathophysiological overlap, including dysregulated innate immunity, barrier dysfunction, and Th17-mediated inflammation. However, whether Na+ overload-related genes (NRGs) exhibit shared transcriptional alterations in IBD and AS remains unclear. This study aimed to characterize the expression patterns of NRGs across IBD and AS and to identify candidate genes associated with both diseases. Methods: Differential expression analysis was performed to identify differentially expressed NRGs (DE-NRGs) in diseased tissues relative to normal tissues. Shared DE-NRGs between IBD and AS were screened and defined as common differentially expressed NRGs (Co-DE-NRGs). We then analyzed the correlations of these Co-DE-NRGs and explored their relationships with immune cell infiltration in target tissues. Four machine learning algorithms were applied to screen key NRGs associated with both IBD and AS. Potential therapeutic agents targeting these core biomarkers were predicted using drug-gene interaction databases, and molecular docking was conducted for further validation. Results: A total of 32 shared Co-DE-NRGs were identified for IBD and AS, with nine key regulatory NRGs recognized: CALR, CD63, CYBA, DYSF, HYOU1, IL1B, JAK1, MMP9, and STAT3. Exploratory MR analysis identified disease-specific associations between genetically predicted expression of NRGs and CD, UC, and AS. Genetically predicted STAT3 expression showed positive associations with CD and UC but an inverse association with AS and therefore did not represent a consistent risk factor across the three diseases. Furthermore, transcriptome-based drug-response analysis identified four candidate agents shared between AS and at least one IBD dataset: ciclosporin, BCL-LZH-4, BRD-K79669418, and CID-5951923. Exploratory molecular docking generated STAT3 binding poses for BCL-LZH-4 and CID-5951923, with DOCK Grid Scores of -35.321896 and -28.361128, respectively. CID-5951923 was selected for representative visualization of its predicted interaction with STAT3. Single-cell RNA-sequencing analysis identified tissue- and cell-type-specific STAT3 mRNA expression patterns in the analyzed IBD colonic and AS peripheral-blood datasets, with monocytes representing a major cell population exhibiting detected STAT3 expression in the AS dataset. Conclusions: These findings identify shared NRG-related transcriptional alterations in IBD and AS, with STAT3 emerging as a candidate gene associated with both diseases. Further experimental studies are required to determine whether these alterations reflect the involvement of NECSO and to evaluate their potential diagnostic or therapeutic relevance.

PMID 42650131
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PubMedThe Journal of small animal practice2026-08-25

Occurrence of infections in dogs receiving ciclosporin in a single-centre UK referral population.

Dormon S S, Walker J J, Gallow G G, Goonan L L et al.

The study aimed (a) to describe the occurrence and nature of new infections in dogs receiving oral ciclosporin and (b) to identify any risk factors associated with the development of a new infection whilst receiving ciclosporin. In this retrospective cohort study, medical records of dogs presented to a private UK referral hospital between March 2015 and September 2022 that received ciclosporin were evaluated. The development of a new infection was classified as confirmed or suspected, based on available data, and the infection was further characterised by causative agent (bacterial, fungal and parasitic) and location (integument, urogenital, hepatobiliary, cardiorespiratory, musculoskeletal and miscellaneous). Risk factors for the development of an infection were assessed using binary logistic regression analysis. Our cohort consisted of 265 dogs with 281 prescribed courses of ciclosporin. Of the included dogs, 33.2% (88/265) developed one or more new infections over the study period. When separated into aetiological groups, 26.0% of dogs (69/265) developed bacterial infections, 4.5% of dogs (12/265) developed fungal infections, 1.1% of dogs (3/265) developed parasitic infections, and 5.6% of dogs (15/265) developed unknown infections. Heavier dogs (increasing body weight OR 1.04, 95% CI 1.01 to 1.07), use of an additional third immunosuppressive agent (OR 1.96, 95% CI 1.09 to 3.51) and those receiving higher daily doses of ciclosporin (>8 mg/kg/day OR 3.01, 95% CI 1.41 to 6.46) were more likely to develop infections. The risk of infection was particularly increased with concurrent use of mycophenolate mofetil (OR 3.43; 95% CI 1.47 to 7.99). The most common locations for infection to occur in were the integument and urogenital systems. Increasing body weight, higher doses of ciclosporin and concurrent use of an additional third immunosuppressive agent, particularly mycophenolate, were risk factors for developing novel infections. The risks of ciclosporin treatment must be considered by the clinician and discussed with owners prior to use.

PMID 42642047
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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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