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Next-generation calcineurin inhibitors for ophthalmic indications.

Abstract
Calcineurin inhibitors (CNIs) are potent immunosuppressants that reversibly inhibit T-cell proliferation and prevent the release of pro-inflammatory cytokines by blocking the activity of calcineurin, a ubiquitous enzyme that is found in cell cytoplasm. CNIs can be highly effective in immune-mediated ophthalmic diseases such as uveitis, dry eye syndrome and inflammatory blepharitis, as well as for the prevention of rejection in corneal transplants. ISA-247/LX-211 is a novel CNI that is in Phase III clinical development for the treatment of various forms of non-infectious uveitis. ISA-247/LX-211 is a rationally designed analog of ciclosporin A that exhibits more predictable pharmacokinetic and pharmacodynamic properties and a 4-fold greater calcineurin inhibition than its parent compound, ciclosporin A. ISA-247/LX-211 has been observed to be effective, well-tolerated, and safe in early clinical trials, exhibiting a much wider therapeutic window compared with classic CNIs, such as ciclosporin A and tacrolimus. An alternative approach to widening the therapeutic window for the therapy of ophthalmic disorders lies in local delivery of CNIs through polymeric implants that release the drug over long periods of time. The silicone matrix episcleral implant LX-201 is in Phase III development at present for the prevention of rejection in high-risk cornea transplantation.
AuthorsEddy Anglade, Randall Yatscoff, Robert Foster, Ulrich Grau
JournalExpert opinion on investigational drugs (Expert Opin Investig Drugs) Vol. 16 Issue 10 Pg. 1525-40 (Oct 2007) ISSN: 1744-7658 [Electronic] England
PMID17922618 (Publication Type: Journal Article, Review)
Chemical References
  • Calcineurin Inhibitors
  • Drug Implants
  • voclosporin
  • Cyclosporine
Topics
  • Animals
  • Calcineurin Inhibitors
  • Clinical Trials as Topic
  • Cyclosporine (pharmacokinetics, pharmacology, therapeutic use)
  • Drug Implants (pharmacokinetics, pharmacology, therapeutic use)
  • Eye Diseases (drug therapy)
  • Humans

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