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Eficacia de la azatioprina en la enfermedad ocular inflamatoria no infecciosa resistente a tratamiento esteroidal sistémico / Role ofAzathioprine in steroid resistant non infectious ocular inflammatory diseases
Cuchacovich, Miguel; Pacheco, Patricio; Díaz, Gonzalo; Rojas, Basilio; Stoppel, Juan; Merino, Guillermo; Verdaguer, Juan Ignacio; Verdaguer, Juan; Villarroel, Francisco.
Affiliation
  • Cuchacovich, Miguel; Universidad de Chile. Hospital Clínico. Departamento de Medicina. Sección de Reumatología. Santiago. CL
  • Pacheco, Patricio; Universidad de Chile. Hospital Clínico. Departamento de Oftalmología. Santiago. CL
  • Díaz, Gonzalo; Universidad de Chile. Santiago. CL
  • Rojas, Basilio; Fundación Oftalmológica Los Andes. Santiago. CL
  • Stoppel, Juan; Fundación Oftalmológica Los Andes. Santiago. CL
  • Merino, Guillermo; Centro Oftalmológico Luis Pasteur. Santiago. CL
  • Verdaguer, Juan Ignacio; Fundación Oftalmológica Los Andes. Santiago. CL
  • Verdaguer, Juan; Fundación Oftalmológica Los Andes. Santiago. CL
  • Villarroel, Francisco; Fundación Oftalmológica Los Andes. Santiago. CL
Rev. méd. Chile ; 135(6): 702-707, jun. 2007. tab
Article in Spanish | LILACS | ID: lil-459572
Responsible library: BR1.1
ABSTRACT

Background:

Topical and systemic steroids are the first line of treatment of non infectious inflammatory ocular disease. Immunosuppresants are reserved as a second line treatment.

Aim:

To evaluate the role ofAzathioprine (AZA) as a coadyuvant immunosuppressive treatment for non infectious ocular inflammatory diseases (OIDs) resistant to systemic steroid therapy in a retrospective, noncomparative interventional case series. Patients and

methods:

Patients using oral Prednisone due to an active or recurrent OID, without clinical response, and not receiving any other immunosuppressive treatment were studied. A standard protocol of oral Prednisone (0.5 mg/kg/ day) and oral AZA (2-3 mg/kg/day) during one year was used. Ocular and systemic monthly evaluations were done including relapse rate, steroid dosage, inflammatory score and visual acuity.

Results:

Thirty patients (10 male) aged 18-75 years (mean 44 years) were studied. Three had bilateral anterior uveitis, one had pars planitis, four had diffuse uveitis, eight Vogt-Koyanahi-Harada syndrome, three Behget's disease, three necrotizing scleritis and eight had retinochoroidopathy A complete initial response was observed in 26 patients (87 percent). The time of response was between 1 to 6 months (mean 2.65 months). Seventeen percent of these had a relapse 6 to 12 months after AZA was started. In 61 percent, visual acuity improved. The ocular inflammatory score decreased in 86.5 percent. Eleven patients had mild controlled side effects that did not require discontinuation of AZA.

Conclusions:

Combined systemic steroid and oral AZA therapy is safe and effective in controlling steroid resistant non infectious inflammatory ocular diseases.
Subject(s)

Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being Health problem: Target 3.3: End transmission of communicable diseases Database: LILACS Main subject: Azathioprine / Uveitis / Immunosuppressive Agents Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2007 Document type: Article Affiliation country: Chile Institution/Affiliation country: Centro Oftalmológico Luis Pasteur/CL / Fundación Oftalmológica Los Andes/CL / Universidad de Chile/CL
Full text: Available Collection: International databases Health context: SDG3 - Health and Well-Being Health problem: Target 3.3: End transmission of communicable diseases Database: LILACS Main subject: Azathioprine / Uveitis / Immunosuppressive Agents Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2007 Document type: Article Affiliation country: Chile Institution/Affiliation country: Centro Oftalmológico Luis Pasteur/CL / Fundación Oftalmológica Los Andes/CL / Universidad de Chile/CL
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