Short-term Effects and Side Effects of Tacrolimus for Behcet's Uveitis

ABSTRACT

PURPOSE: To investigate the clinical effects and side effects of Tacrolimus for ocular Behcet's disease. METHODS: Eight patients (male 5, age 35+/-7.5 (25-48) years) with Behcet's uveitis, refractory posterior uveitis unresponsive to combination treatment with cyclosporine, azathioprine, and oral steroid or significant cyclosporine-related adverse effects were recruited prospectively, and cyclosporine was switched to Tacrolimus. Visual acuity, degree of anterior chamber, and vitreous haze were compared before the conversion and three months after. Oral glucose tolerance, plasma insulin, cholesterol, creatinine, and aspartate (AST)/alanine aminotransferase (ALT) were measured to monitor systemic effects. RESULTS: Visual acuity did not change significantly after conversion to Tacrolimus. Anterior chamber (seven patients) and vitreous (four patients) inflammation were found before conversion and decreased or disappeared after conversion. Overall plasma levels of glucose, insulin, creatinine, and AST/ALT were similar before and after conversion. However, cholesterol was significantly decreased after conversion (p=0.028). One patient developed diabetes mellitus. CONCLUSIONS: Tacrolimus may be effective for Behcet's uveitis unresponsive to or intolerable of traditional treatments. In addition, periodic monitoring for side effects, such as hyperglycemia and diabetes mellitus, may be necessary.