cyclosporine / Generic mfg. - LARVOL DELTA

Cholestatic Liver Injury From Hepatic Infiltration by T-Cell Large Granular Lymphocytic Leukemia (ACG 2026) - "His LFTs normalized in 2018 following exposure to various LGLL regimens: methotrexate, cyclosporine, and cyclophosphamide. The diagnosis can be difficult to confirm given the involved T-cells may mimic many other inflammatory conditions and often requires support from hematopathology expertise. This patientâs persistent cholestatic liver injury after peripheral blood LGLL remission suggests there may be irreversible hepatic injury from LGLL infiltration, lack of response within the involved hepatic tissue, contribution from nodular regenerative hyperplasia or concomitant EBV-related hepatitis."

Congestive Heart Failure • Epstein-Barr Virus Infections • Fibrosis • Heart Failure • Hematological Malignancies • Hepatitis B • Hepatology • Immunology • Infectious Disease • Leukemia • Liver Cirrhosis • Liver Failure • T-Cell Large Granular Lymphocyte Leukemia

CARMIL2-Associated Enteropathy in a Patient With Cryptosporidiosis (ACG 2026) - "Case Description/ A 47-year-old woman with CARMIL2-related immunodeficiency (on monthly IVIG) and necrotizing aspergillosis (on voriconazole) was admitted for CMV retinitis...Nitazoxanide was started; diarrhea initially improved, then worsened to 13 bowel movements/day (up to 1.5L stool/day, requiring rectal tube)...Immunosuppressants (anti-TNF agents, azathioprine, cyclosporine) have shown variable results, with increased risk of infections...More case reports and research are needed to guide management and improve outcomes. Figure: Rectal mucosal ulceration with subsequent pathology notable for increased crypt cell apoptosis, and positive for cryptosporidium Figure: Duodenal lamina propria inflammation, villous blunting and scattered intra-epithelial lymphocytes"

Clinical • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Ocular Inflammation • Ophthalmology • Pancreatitis • Pneumonia • Primary Immunodeficiency • Respiratory Diseases • Retinal Disorders • CARMIL2

Not Your Typical Wound: Chest Wall Pyoderma Gangrenosum in the Setting of Crohn's Disease (ACG 2026) - "Case Description/ A 41-year-old female with a 3-year history of UC, previously well-controlled on upadacitinib, presented to the ED with a 5-month progressive chest wall wound, previously managed with multiple debridements, negative-pressure wound therapy, and several antibiotic courses at an outside facility...First-line therapies for PG include systemic corticosteroids and cyclosporine, with infliximab being the most studied biological, particularly in patients with IBD...Figure: Figure 2. Chest wall wound at 2-week follow-up after initiation of infliximab, showing significant improvement in wound healing."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Pyoderma Gangrenosum • Ulcerative Colitis

Recurrent Sickle Cell Hepatopathy After Liver Transplantation Despite Guideline-Directed Red Blood Cell Exchange (ACG 2026) - "His post-LT course was complicated by a right frontal subarachnoid hemorrhage and tacrolimus neurotoxicity, necessitating a switch to cyclosporine and mycophenolate mofetil. Ischemia from sinusoidal sickling can occur even at lower HbS thresholds, potentially due to the increased metabolic demands or altered hemodynamics of the allograft. Figure: graph showing progression of liver enzymes through the course of hospitalization Figure: Liver biopsy showing sickling of cells in hepatic vasculature"

Cardiovascular • Cholestasis • Chronic Kidney Disease • CNS Disorders • Epilepsy • Genetic Disorders • Hematological Disorders • Hepatology • Liver Failure • Sickle Cell Disease • Subarachnoid Hemorrhage • Transplantation

Multifactorial Encephalopathy: A Challenging Case of Tacrolimus Toxicity, Posterior Reversible Encephalopathy Syndrome (PRES), and Steroid Delirium in a Post-Transplant Patient (ACG 2026) - "An MRI was performed revealing PRES, as a result cyclosporine was discontinued and he was maintained on weekly basiliximab, prednisone and mycophenolate...Four weeks post transplant, he was initiated on everolimus with improvement in liver enzymes and he was discharged with full neurologic recovery...While tacrolimus is typically considered more likely to pose neurotoxic side effects than cyclosporine, patients with malnutrition may be at significant risk of cyclosporine induced toxicity. Calcineurin inhibitors are the cornerstone of therapy post-transplant; however, this paradigm must be challenged in cases of PRES refractory to first line measures."

Clinical • Post-transplantation • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Inflammatory Bowel Disease • Insomnia • Primary Sclerosing Cholangitis • Sleep Disorder • Transplantation • Ulcerative Colitis

HBV Reactivation With Seroreversion During Kidney Allograft Failure (ACG 2026) - "Mycophenolate was discontinued, cyclosporine was reduced and later stopped, and prednisone 5 mg daily was continued...Renal dose of entecavir was started in January 2024...HBsAg-negative, anti-HBc-positive transplant recipients remain at risk for reactivation, including during major immunosuppression changes. For patients with prior HBV exposure, particularly from populations with higher HBV prevalence, transplant programs should document baseline HBV serology and HBV DNA, consider starting antiviral therapy post-transplant and continue serial HBsAg and HBV DNA monitoring while on immunosuppression."

Fibrosis • Glomerulonephritis • Hepatitis B • Hepatology • Human Immunodeficiency Virus • IgA Nephropathy • Immunology • Infectious Disease • Nephrology • Solid Organ Transplantation

What a Headache: Managing Tacrolimus-Induced Reversible Cerebral Vasoconstriction Syndrome in Early Liver Transplantation (ACG 2026) - "This case highlights FK-induced RCVS occurring after a recent liver transplant, requiring watchful transition to cyclosporine. Case Description/ A 62-year-old female six months post-OLT for decompensated MASH cirrhosis, maintained on FK and mycophenolate mofetil, with prior gastric variceal bleed status post PARTO, spontaneous bacterial peritonitis, hepatic encephalopathy, and portal vein thrombosis status post thrombectomy, presented with sudden-onset, severe headaches without preceding trauma...Figure: Figure 2. Sagittal CT with focal moderate stenosis of the A2/A3 segment and distal segmental stenosis to middle cerebral artery (MCA, 2a); mild distal luminal irregularities to the M2 and M3 branches of the right MCA (2b)."

Cardiovascular • CNS Disorders • Fibrosis • Hematological Disorders • Hepatic Encephalopathy • Hepatology • Immunology • Metabolic Dysfunction-Associated Steatohepatitis • Mood Disorders • Subarachnoid Hemorrhage • Thrombosis • Transplant Rejection • Transplantation

Inpatient Outcomes Among Patients With Steroid-Refractory Acute Severe Ulcerative Colitis Managed With Medical Rescue Therapy Versus Colectomy: A Propensity-Matched Retrospective Cohort Study (ACG 2026) - "Following propensity matching, 1,483 patients were included in each cohort. Patients undergoing colectomy had higher rates of organ failure (12.07% vs 9.24%, p=0.012), sepsis (8.56% vs 6.34%, p=0.021), acute respiratory failure (4.65% vs 2.63%, p=0.003), and mechanical ventilation (2.90% vs 1.01%, p< 0.001) compared with patients managed with infliximab or cyclosporine rescue therapy. Rates of serious infection, bacteremia, pneumonia, Clostridioides difficile infection, and AKI were similar between groups."

Retrospective data • Colorectal Cancer • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Pneumonia • Respiratory Diseases • Septic Shock • Solid Tumor • Ulcerative Colitis

Comparative Outcomes of Advanced Medical Rescue Therapies in Steroid-Refractory Acute Severe Ulcerative Colitis: An Updated Systematic Review and Network Meta-Analysis (ACG 2026) - "Interventions included standard infliximab (IFX), accelerated or intensified IFX induction, cyclosporine, tacrolimus, tofacitinib, upadacitinib, and other advanced therapies. Twenty-three studies (8 RCTs and 15 cohort studies) involving approximately 2,167 patients were included. In PREDICT-UC, intensified, accelerated, and standard IFX induction showed no significant differences in clinical outcomes or 3-month colectomy rates. Three-month colectomy occurred in 6.7%, 19.1%, and 11.6% of patients receiving intensified, accelerated, and standard induction, respectively."

Metastases • Retrospective data • Review • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Ulcerative Colitis

Fecal Microbiota Transplantation for the Management of Immune Effector Cell-Associated Enterocolitis Following CAR-T Cell Therapy: A Novel Application (ACG 2026) - "Case Description/ A 79y/o female with refractory multiple myeloma (MM) diagnosed in 2008 underwent multiple lines of therapy before receiving CAR-T with ciltacabtagene autoleucel in August 2025...The patient was started on budesonide 9mg daily and mesalamine 1g QID; however, symptoms persisted, which prompted IV cyclosporine...Further IEC-AE treatment included 3 doses of vedolizumab and tacrolimus maintenance, with some improvement of diarrhea, but unable to maintain the weight...Colonoscopic images post-CAR-T cell therapy and subsequent fecal microbiota transplant Figure: Graph 1. Longitudinal treatment timeline: From induction to CAR-T and IEC-AE management"

CAR T-Cell Therapy • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Infectious Disease • Multiple Myeloma • Neutropenia • Transplantation • CD8

Pseudomembranous Colitis Beyond Clostridioides difficile : A Diagnostic Pattern Rather Than a Diagnosis (ACG 2026) - "Case Description/ A 55-year-old man with alcohol-associated cirrhosis status post liver and deceased-donor kidney transplant, type 2 diabetes mellitus, hypertension, and chronic pancreatitis was admitted with ESBL E. coli bacteremia and treated with ertapenem. Prednisone and cyclosporine were continued while MMF was held...The patient was empirically treated with oral vancomycin with complete resolution of diarrhea...This case highlights the importance of maintaining a broad differential diagnosis while recognizing that pseudomembranous colitis can strongly suggest C. difficile despite absent stool confirmation when clinical, endoscopic, and therapeutic responses align. Figure: Flexible sigmoidoscopy demonstrating pseudomembranes Figure: Flexible sigmoidoscopy demonstrating pseudomembranes"

Cardiovascular • Cytomegalovirus Infection • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Pancreatitis • Type 2 Diabetes Mellitus

When the Barrier Breaks: Fatal Invasive Candida Guilliermondii Colitis in Severe Gastrointestinal GVHD (ACG 2026) - "Case Description/ A 43-year-old patient with relapsed mixed phenotype acute leukemia underwent second allogeneic stem cell transplant with double 4/8 umbilical cord donors after Flu/Mel conditioning and cyclosporine/MMF prophylaxis...Necrosis raised concern for fungal colitis, prompting isavuconazole and ruxolitinib escalation to 10 mg BID...Despite antibiotics, micafungin/isavuconazole, and vedolizumab, she died from recurrent GI bleeding due to Candida superinfection of severe, treatment-refractory GVHD enterocolitis...Figure: Figure 2. Laboratory trends through the course"

Candidiasis • Gastroenterology • Gastrointestinal Disorder • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia

Immunosuppressant Management in Rheumatology Patients Undergoing Elective Total Shoulder Arthroplasty (clinicaltrials.gov) - P2 | N=80 | Recruiting | Sponsor: NYU Langone Health | Not yet recruiting ➔ Recruiting | Trial completion date: Sep 2027 ➔ Jan 2028 | Initiation date: Sep 2025 ➔ Dec 2025 | Trial primary completion date: Sep 2027 ➔ Jan 2028

Enrollment open • Trial completion date • Trial initiation date • Trial primary completion date • Orthopedics • Psoriatic Arthritis • Rheumatology

Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis after failure of biologic or targeted synthetic therapy: a systematic review and network meta-analysis. (PubMed, Cochrane Database Syst Rev) - "We found high-certainty evidence that nine therapies and moderate-certainty evidence that two therapies provide a clinically important benefit in improving disease activity compared to placebo for people with rheumatoid arthritis after failure of b/ts DMARD therapy. There was significant uncertainty surrounding treatment-related harms, with the evidence having been downgraded for serious or extremely serious imprecision. Pair-wise comparisons showed no significant differences among therapies, although the certainty of evidence was low. The lack of clarity regarding safety and comparative efficacy suggests that treatment decisions should be guided by individual patient characteristics and preferences."

Clinical • Journal • Retrospective data • Review • Fatigue • Immunology • Infectious Disease • Inflammatory Arthritis • Oncology • Pain • Rheumatoid Arthritis • Rheumatology • IL6

Hypomagnesemia as a reversible complication of cyclosporine in pediatric nephrotic syndrome: a case report. (PubMed, Child Kidney Dis) - "Current guidelines lack clear recommendations regarding magnesium surveillance in pediatric SRNS receiving cyclosporin. This case underscores a critical gap in practice and calls for the integration of magnesium monitoring into standard care for this vulnerable population."

Journal • Glomerulonephritis • Nephrology • Pediatrics • Renal Disease

Hyperbaric Oxygen Therapy as Adjunctive Treatment for Steroid-Refractory Iec-Colitis After BCMA CAR T: A Two-Case Experience (IMS 2026) - "To date, no standardized treatment exists, with limited response to TNF or α4β7 blockade (e.g., infliximab and vedolizumab) in steroid-refractory cases. Similarly, corticosteroids combined with T cell–directed therapies (e.g., cyclosporine, ruxolitinib) have demonstrated limited efficacy... Patient 1, a 75-year-old male, presented on Day +90 post–cilta-cel with grade 3 non-bloody diarrhea refractory to corticosteroids and ruxolitinib... To our knowledge, this is the first report of HBOT use in IEC-EC. Adjunctive HBOT was feasible, well tolerated, and associated with clinical improvement in both patients. While causality cannot be established due to other concurrent therapies, these findings support the need for prospective evaluation of HBOT as a non-immunosuppressive, mucosal-protective adjunct in IEC-EC."

CAR T-Cell Therapy • Clinical • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Multiple Myeloma

Moderate-to-severe chronic spontaneous urticaria is associated with increased risk of immune-mediated diseases: A population-based study. (PubMed, PLoS One) - "We propensity matched patients with ≥2 ICD-10 diagnoses of idiopathic urticaria treated with omalizumab, dupilumab, or cyclosporine (moderate-to-severe disease) to age-, sex-, race-, ethnicity-, comorbidity-, and family history-matched counterparts who were never treated with biologics or cyclosporine (mild disease). Patients with moderate-to-severe CSU had a significantly increased risk of developing rheumatoid arthritis OR=1.34 (95% CI: 1.12 to 1.60, p = 0.001) and Sjögren's syndrome OR=1.04 (1.63-2.56, p < 0.0001), after adjusting for clinical factors and multiple hypothesis testing (Bonferroni's alpha ≤0.00333). Moderate-to-severe CSU is associated with an increased risk of rheumatoid arthritis and Sjögren's syndrome compared to mild CSU."

Journal • Retrospective data • Cardiovascular • Chronic Spontaneous Urticaria • Dermatology • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Sjogren's Syndrome • Urticaria

Impact of kidney and liver transplant immunosuppression regimens on sinonasal disease. (PubMed, Am J Otolaryngol) - "When comparing common immunosuppression for kidney and liver transplant, basiliximab was associated with a higher rate of sinonasal disease and AR compared to ATG. For maintenance immunosuppression, treatment with tacrolimus-based regimens was associated with a higher rate of AR and acute IFS."

Journal • Allergic Rhinitis • Chronic Rhinosinusitis With Nasal Polyps • Immunology • Inflammation • Nasal Polyps • Otorhinolaryngology • Respiratory Diseases • Sinusitis • Solid Organ Transplantation • Transplantation

Chidamide-maintained long-term clinical remission with persistent T-Cell clone in refractory T-LGL leukemia-associated pure red cell aplasia: A six-year follow-up. (PubMed, Leuk Res Rep) - "We report a case of refractory T-LGL leukemia complicated by PRCA that was resistant to cyclosporine (CsA). Then the patient achieved rapid disease control with chidamide plus thalidomide in the early phase, and has maintained long-term remission for six years on chidamide monotherapy after thalidomide discontinuation. Notably, clonal T-cell receptor (TCR) variable β-chain (Vβ) 3 persisted on flow cytometry throughout the treatment course. As an epigenetic modulator, chidamide represents a more convenient and promising therapeutic strategy for managing T-LGL leukemia, prompting us to present this case."

Journal • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • T-Cell Large Granular Lymphocyte Leukemia

Clinical and laboratory manifestations and treatment of children with TNFRSF1A gene variants. (PubMed, World J Clin Pediatr) - "Variants in the TNFRSF1A gene may cause a wide range of clinical symptoms, including eye and intestinal lesions that are not typical of sJIA. All patients with fever and unusual sJIA symptoms should have molecular genetic testing for TNFRSF1A variants to confirm or exclude AID early. Early diagnosis enables timely therapy and prevents complications. Tocilizumab (39.3%), canakinumab (33.3%), and TNF inhibitors (21.2%) achieved remission in children with TNFRSF1A variants. Some patients required multiple bDMARD switches to achieve remission, highlighting the complexity of treatment decisions in this group."

Journal • Amyloidosis • CNS Disorders • Gastrointestinal Disorder • Idiopathic Arthritis • Immunology • Infectious Disease • Inflammation • Oncology • Otorhinolaryngology • Pain • Pediatrics • Rheumatology • Ventriculomegaly • TNFRSF1A

Obinutuzumab Compared to Cyclosporine with Steroids for the Treatment of Primary Membranous Nephropathy: A Propensity Score-Matched Analysis. (PubMed, Kidney360) - "Our study demonstrated that obinutuzumab is associated with higher remission rates at 24 months, faster immunological remission and less infections than cyclosporine combined with corticosteroids in the treatment of PMN."

Journal • Glomerulonephritis • Infectious Disease • Nephrology • Renal Disease

Addition of thiotepa to a busulphan based conditioning regimen does not improve survival in patients allografted for acute myeloid leukaemia and myelodysplasia: Results of the UK impact cosi trial (ASH 2025) - "Thiotepa (Thio)is an alkylating agent whose addition to a busulphan (Bu)/fludarabine (Flu) conditioning regimen hasbeen shown in retrospective studies to improve survival in patients transplanted for AML using bothmatched unrelated and haploidentical donors, consequent upon a reduction in post-transplant relapse.As a result, Flu/Bu/Thio conditioning regimens are increasingly used in patients allografted for high riskAML despite the absence of prospective randomised trials supporting this practice...All patients received ciclosporin/ATG-based GVHD prophylaxis... This prospective randomised trial demonstrates that the addition of Thio to either a Flu/Bubased MAC or RIC regimen does not improve survival in patients allografted for AML or MDS and wasassociated with an increased TRM in both settings. Further prospective studies examining the ability ofThio to reduce the risk of disease relapse in high risk patients whilst at the same time limiting transplanttoxicity are merited."

Clinical • Acute Myelogenous Leukemia • Graft versus Host Disease • Hematological Malignancies • Immunology • Leukemia • Myelodysplastic Syndrome

Management of chronic urticaria: Current status and future prospect. (PubMed, J Eur Acad Dermatol Venereol) - "Omalizumab has transformed the treatment of antihistamine-refractory disease, while newer options such as dupilumab and remibrutinib further expand the therapeutic landscape. Ciclosporin remains an effective option in selected patients, particularly those with severe or difficult-to-treat disease, but requires careful safety monitoring...Despite recent advances, important unmet needs remain, including reliable biomarkers for endotyping, evidence-based selection among emerging therapies, better data in children and other special populations, standardized definitions of remission and relapse and disease-modifying strategies. Future management is expected to move towards biomarker-driven, personalized care, enabling more precise treatment selection and sustained disease control."

Journal • Review • Cardiovascular • Chronic Spontaneous Urticaria • Dermatology • Immunology • Inflammation • Urticaria

BUMEL vs MEL-200 prior autologous transplant for patients with newly diagnosed multiple myeloma previously treated with bortezomib, lenalidomide and dexamethasone: final results of a phase 3 trial (IMW 2022) - "Attempts to improve this conditioning have included TBI plus melphalan 140 mg/m2, and particularly the busulfan plus melphalan combination (BUMEL), among others... This is an open label, randomized phase 3 study followed by a maintenance trial that compared lenalidomidedexamethasone +/- ixazomib (Rosiñol L. et al...One patient in the BUMEL group had a graft failure successfully treated with cyclosporin... This randomized trial indicate that MEL200 should remain as the standard of care based on efficacy and toxicity, except for high-risk ISS patients, in which BUMEL provides a clear PFS benefit."

Clinical • P3 data • Bone Marrow Transplantation • Hematological Malignancies • Infectious Disease • Mucositis • Multiple Myeloma • Oncology • Transplantation • CD34

Extended letermovir prophylaxis for cytomegalovirus in intermediate-risk (R+) kidney transplant recipients: A pilot real-world cohort study (TTS 2026) - "While valganciclovir has been widely used for prophylaxis, its myelotoxicity and potential drug-related adverse events may limit long-term administration...Maintenance immunosuppression consisted of tacrolimus (Tac) plus everolimus (EVR) in 21 patients and Tac plus mycophenolate mofetil (MMF) in 2 patients...One patient experienced diarrhea attributed to tacrolimus, leading to temporary interruption of letermovir; after conversion from Tac to cyclosporine, letermovir was successfully resumed without further complications... In this pilot real-world cohort of CMV R+ kidney transplant recipients, letermovir prophylaxis initiated early after transplantation and continued for approximately 200 days was safe and effective. No CMV DNAemia or acute rejection episodes occurred during prophylaxis, and hematologic toxicity was absent. Our findings suggest that letermovir may represent a viable prophylactic strategy in intermediate-risk (R+) kidney transplant recipients,..."

Clinical • Real-world • Real-world evidence • Bone Marrow Transplantation • Cytomegalovirus Infection • Hematological Disorders • Infectious Disease • Leukopenia • Neutropenia • Transplant Rejection • Transplantation