Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study

To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. A nonrandomized retrospective case-series study analyzed data from 22 patients with Behçet's disease uveitis, from a single Uveitis Service, São Paulo, Brazil (period 1978-2007),...

Full description

Saved in:

Bibliographic Details
Published in:	Arquivos brasileiros de oftalmologia Vol. 73; no. 1; pp. 40 - 46
Main Authors:	Zaghetto, Juliana Marques, Yamamoto, Mirian Mina, Souza, Murilo Barreto, Silva, Felipe Theodoro Bezerra Gaspar Carvalho da, Hirata, Carlos Eduardo, Olivalves, Edilberto, Yamamoto, Joyce Hisae
Format:	Journal Article
Language:	English
Published:	Brazil Conselho Brasileiro de Oftalmologia 01-01-2010
Subjects:	Adolescent Adult Behcet Syndrome - complications Behcet Syndrome - drug therapy Child Chlorambucil - adverse effects Chlorambucil - therapeutic use Cyclosporine - adverse effects Cyclosporine - therapeutic use Female Follow-Up Studies Humans Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use Male OPHTHALMOLOGY Retrospective Studies Treatment Outcome Uveitis - drug therapy Uveitis - etiology Young Adult Chlorambucil Retrospective studies Uveíte Uveitis Estudos retrospectivos Síndrome de Behçet Clorambucil Cyclosporine Ciclosporina Imunossupressores Behçet syndrome Immunosuppressive agents
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. A nonrandomized retrospective case-series study analyzed data from 22 patients with Behçet's disease uveitis, from a single Uveitis Service, São Paulo, Brazil (period 1978-2007), under systemic chlorambucil and/or cyclosporine A, for at least 6 months with a minimum one-year follow-up. Drug efficacy was measured by reduction in relapse rate and reduction of prednisone dose. Patients (10M/12F) mean age was 29 (range 10-43) years-old at the onset of uveitis. The median duration of followup was 11 (range 1-29) years-old. Chlorambucil (2-6 mg/day) was used in 13 patients and cyclosporine A (3-5 mg/kg/day) in 9 patients at initiation. Drugs were switched because of no effectiveness or side-effects. Chlorambucil was effective in 78.5% (11/14) and induced disease remission in 43% (6/14) of patients, whereas cyclosporine A was effective in 57% (8/14) of patients. Chlorambucil and cyclosporine A were discontinued due to side effects in 21% (leucopenia) and in 57% of patients (nephrotoxicity, 36% and gastrointestinal complications, 21%), respectively. No case of late malignancy was observed. 36% (16/44) of eyes had final visual acuity < or =0.1, among which 69% (11/16) had already this visual acuity at the first visit. This study reiterates previous data that chlorambucil can induce long-term remission of Behçet's disease uveitis, whereas cyclosporine is effective but side effects limit its use. Chlorambucil therapy may still be a reasonable option in patients with intractable, sight-threatening Behçet's disease uveitis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0004-2749 1678-2925 1678-2925
DOI:	10.1590/S0004-27492010000100007