A Cochrane review included 3 studies with a total of 390 subjects. Compared with placebo, cyclosporin A did not significantly reduce mortality (RR 0.92, 95% CI 0.59 to 1.45), or mortality or liver transplantation (RR 0.85, 95% CI 0.60 to 1.20). Cyclosporin A significantly improved pruritus (SMD -0.38, 95% CI -0.63 to -0.14), but not fatigue. Cyclosporin A significantly reduced alanine aminotransferase (WMD -41 U/L, 95% CI -63 to -18) and increased serum albumin level (WMD 1.66 g/L, 95% CI 0.26 to 3.05). Significantly more patients experienced adverse events in the cyclosporin A group than in the placebo group, especially renal dysfunction (Peto odds ratio 5.56, 95% CI 2.52 to 12.27) and hypertension (SMD 0.88, 95% CI 0.27 to 1.48).
Comment: The quality of evidence is downgraded by study quality (inadequate follow up; all the trials had shorter follow-up than the estimated median survival of primary biliary cirrhosis 10 to 15 years).