Long-term results of therapy with mycophenolate mofetil in chronic non-infectious uveitis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Deshka Doycheva & Manfred Zierhut & Gunnar Blumenstock & Nicole Stuebiger & Christoph Deuter
- چاپ و سال / کشور: 2011
Description
Background Short-term studies have shown mycophenolate mofetil (MMF) to be a useful immunosuppressive agent for the treatment of intraocular inflammation. The aim of our study was to assess the long-term efficacy and tolerability of MMF in patients with chronic non-infectious uveitis, as well as to analyze disease course following discontinuation of therapy. Methods This is a retrospective case series on 60 uveitis patients treated with MMF with a follow-up period of at least 5 years. The main outcome measures were: control of inflammation, corticosteroid-sparing potential, side-effects, ability to stop/taper MMF treatment because of effective control of inflammation and relapse rate after therapy discontinuation. Results Control of intraocular inflammation (efficacy of MMF), defined as inactive disease under prednisolone dose of .10 mg daily, was achieved in 43 of 60 patients (72%) after 1 year of MMF treatment at a rate of 0.72 per patientyear (PY), and in 45 of 55 patients (82%) after 2 years therapy (rate: 0.41/PY). An improvement (3 lines) or stabilization of visual acuity was observed in 49 patients (82%), and a worsening in 11 patients (18%, 95% CI: 10. 30%). The probability of discontinuing prednisolone, estimated by the Kaplan.Meier method, was 40% after 5 years therapy. The probability of discontinuing mycophenolate mofetil due to efficacy was 33% after 5 years treatment. Recurrences of uveitis occurred in six of 21 patients (29%, rate: 0.11/PY) after MMF discontinuation due to efficacy. The treatment was stopped because of inefficacy in 12 patients (rate: 0.05/PY) and because of side-effects in four patients (rate: 0.02/PY). The rate of adverse effects during MMF therapy was 0.17/PY.
Graefes Arch Clin Exp Ophthalmol (2011) 249:1235–1243 DOI 10.1007/s00417-011-1731-8 Received: 1 March 2011 / Revised: 21 April 2011 / Accepted: 22 April 2011 / Published online: 1 July 2011
