Document Detail


The outcomes of mycophenolate mofetil therapy combined with systemic corticosteroids in acute uveitis associated with Vogt-Koyanagi-Harada disease.
MedLine Citation:
PMID:  22971163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study the effectiveness of mycophenolate mofetil (MMF) as first-line therapy combined with systemic corticosteroids in acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease. The outcomes in this group were compared with those of another group of patients with VKH disease who were treated with corticosteroid monotherapy or with delayed addition of immunomodulatory therapy.
METHODS: This prospective study included 19 patients (38 eyes) diagnosed with acute uveitis associated with VKH disease.
RESULTS: The mean follow-up period was 27.0 ± 11.1 months (range 16-54 months). Corticosteroid-sparing effect was achieved in all patients. The mean interval between starting treatment and tapering prednisone to 10 mg or less daily was 5.1 ± 1.2 months (range 3-7 months). Ten (53%) patients discontinued treatment without relapse of inflammation. The mean time observed of treatment was 17.3 ± 11.9 months (range 3-41.5 months). Visual acuity of 20/20 was achieved by 38% of the eyes in the corticosteroid group and by 74% in the corticosteroid + MMF group (p < 0.001). Recurrent inflammation of ≥3 times was reduced significantly (p = 0.0383) in the corticosteroid + MMF group (3%) as compared to corticosteroid group (18%). Development of all complications was significantly higher in the corticosteroid group (43%) compared with the corticosteroid + MMF group (8%) (p < 0.001). None of the eyes in the corticosteroid + MMF group developed 'sunset glow fundus'.
CONCLUSIONS: Addition of MMF as first-line therapy to corticosteroids in patients with acute uveitis associated with VKH disease leads to significant reduction in recurrences of uveitis and development of late complications and significantly improves visual outcome.
Authors:
Ahmed M Abu El-Asrar; Suhail Hemachandran; Hani S Al-Mezaine; Dustan Kangave; Abdulrahman M Al-Muammar
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-12
Journal Detail:
Title:  Acta ophthalmologica     Volume:  90     ISSN:  1755-3768     ISO Abbreviation:  Acta Ophthalmol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-03-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  e603-8     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.
Affiliation:
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. abuasrar@ksu.edu.sa
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Administration, Oral
Adolescent
Adult
Child
Coloring Agents / diagnostic use
Drug Therapy, Combination
Female
Fluorescein Angiography
Follow-Up Studies
Glucocorticoids / administration & dosage,  therapeutic use*
Humans
Immunosuppressive Agents / therapeutic use*
Indocyanine Green / diagnostic use
Infusions, Intravenous
Male
Methylprednisolone / administration & dosage,  therapeutic use
Mycophenolic Acid / analogs & derivatives*,  therapeutic use
Ophthalmoscopy
Prednisone / administration & dosage,  therapeutic use
Prospective Studies
Recurrence / prevention & control
Treatment Outcome
Uveitis, Posterior / diagnosis,  drug therapy*,  etiology
Uveomeningoencephalitic Syndrome / complications,  diagnosis,  drug therapy*
Visual Acuity / physiology
Young Adult
Chemical
Reg. No./Substance:
0/Coloring Agents; 0/Glucocorticoids; 0/Immunosuppressive Agents; 24280-93-1/Mycophenolic Acid; 3599-32-4/Indocyanine Green; 53-03-2/Prednisone; 83-43-2/Methylprednisolone; 9242ECW6R0/mycophenolate mofetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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