• Proactive management includes the intermittent, but scheduled use of topical corticosteroids or
topical calcineurin inhibitors to areas of the body that frequently have recurrent disease.
Dosage reduction may decrease toxicities; however, additional pharmaceutical drugs are often required to counteract the adverse effects of
calcineurin inhibitor therapy.
For example, CRAC channels in T cells have been clinically validated as important drug targets through human mutations and the use
of calcineurin inhibitors that act downstream from CRAC channels.
In the cohort of patients who received transplants from mismatched unrelated donors, all 43 patients received four doses of abatacept with
a calcineurin inhibitor and methotrexate.
To serve as the control, researchers looked at data from a national database of matched patients receiving two commonly used regimens to prevent GvHD —
a calcineurin inhibitor and methotrexate (CNI / MTX) or a calcineurin inhibitor and methotrexate plus anti-thymocyte globulin (+ ATG).