Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents
Abstract Background To report the switch rate of conventional immunosuppressive (CIS) therapies to the biological agents (BA) in patients with refractory Behcet’s uveitis (BU). Methods In this retrospective study, clinical records were reviewed of 76 patients’ 116 eyes presenting with BU who had bee...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-018-0929-5 |
| _version_ | 1817977097184870400 |
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| author | Hande Celiker Haluk Kazokoglu Haner Direskeneli |
| author_facet | Hande Celiker Haluk Kazokoglu Haner Direskeneli |
| author_sort | Hande Celiker |
| collection | DOAJ |
| description | Abstract Background To report the switch rate of conventional immunosuppressive (CIS) therapies to the biological agents (BA) in patients with refractory Behcet’s uveitis (BU). Methods In this retrospective study, clinical records were reviewed of 76 patients’ 116 eyes presenting with BU who had been treated with immunosuppressive drug therapy. Mann Whitney U test was used for the intergroup comparisons of parameters without normal distribution as well as calculation of descriptive statistical methods (mean, standard deviation, median, frequency and rate). Wilcoxon Signed Ranks test was used for the intragroup comparisons of parameters without normal distribution. Pearson’s Chi-Square test and Fisher-Freeman-Halton test were used for the comparisons of qualitative data. Results Except for one, all patients were first treated with CIS regimens for BU. Thirty-one patients (41.3%) who were unresponsive to CIS regimens were switched to IFNα2a therapy. After that, eight of these cases were switched to the anti-TNF-α treatments. The presence of initial ocular complications were found to be statistically higher in BA treated patients than the CIS treated cases (p < 0.001). Both in CIS treated and in BA treated cases, an increase in visual acuity (VA) was observed during the last examination compared to the initial examination and was significant (p < 0.001 and p = 0.018, respectively). Conclusions CIS treatment was found to be effective and safe, as suggested in the management guidelines for severe BU. Biological therapy was also found effective for the improvement of the VA. We observed that 58.7% of cases could be treated with strong immunosuppressive therapies, however, nearly half of the patients could have lost their VA if BAs were not existent. During the treatment course of severe cases with BU, classical therapy stage must still be protected as the first-line therapy due to the their reasonable activity and safety. |
| first_indexed | 2024-04-13T22:11:49Z |
| format | Article |
| id | doaj.art-56b3b40227c8498ab36841fc6bcb7d5f |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-04-13T22:11:49Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-56b3b40227c8498ab36841fc6bcb7d5f2022-12-22T02:27:41ZengBMCBMC Ophthalmology1471-24152018-10-011811710.1186/s12886-018-0929-5Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agentsHande Celiker0Haluk Kazokoglu1Haner Direskeneli2Department of Ophthalmology, Marmara University School of MedicineDepartment of Ophthalmology, Marmara University School of MedicineDivision of Rheumatology, Marmara University School of Medicine Fevzi Çakmak MahAbstract Background To report the switch rate of conventional immunosuppressive (CIS) therapies to the biological agents (BA) in patients with refractory Behcet’s uveitis (BU). Methods In this retrospective study, clinical records were reviewed of 76 patients’ 116 eyes presenting with BU who had been treated with immunosuppressive drug therapy. Mann Whitney U test was used for the intergroup comparisons of parameters without normal distribution as well as calculation of descriptive statistical methods (mean, standard deviation, median, frequency and rate). Wilcoxon Signed Ranks test was used for the intragroup comparisons of parameters without normal distribution. Pearson’s Chi-Square test and Fisher-Freeman-Halton test were used for the comparisons of qualitative data. Results Except for one, all patients were first treated with CIS regimens for BU. Thirty-one patients (41.3%) who were unresponsive to CIS regimens were switched to IFNα2a therapy. After that, eight of these cases were switched to the anti-TNF-α treatments. The presence of initial ocular complications were found to be statistically higher in BA treated patients than the CIS treated cases (p < 0.001). Both in CIS treated and in BA treated cases, an increase in visual acuity (VA) was observed during the last examination compared to the initial examination and was significant (p < 0.001 and p = 0.018, respectively). Conclusions CIS treatment was found to be effective and safe, as suggested in the management guidelines for severe BU. Biological therapy was also found effective for the improvement of the VA. We observed that 58.7% of cases could be treated with strong immunosuppressive therapies, however, nearly half of the patients could have lost their VA if BAs were not existent. During the treatment course of severe cases with BU, classical therapy stage must still be protected as the first-line therapy due to the their reasonable activity and safety.http://link.springer.com/article/10.1186/s12886-018-0929-5Anti-TNF-α therapyBehçet’s uveitisImmunosuppressive therapyInterferon therapyUveitis |
| spellingShingle | Hande Celiker Haluk Kazokoglu Haner Direskeneli Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents BMC Ophthalmology Anti-TNF-α therapy Behçet’s uveitis Immunosuppressive therapy Interferon therapy Uveitis |
| title | Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents |
| title_full | Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents |
| title_fullStr | Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents |
| title_full_unstemmed | Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents |
| title_short | Conventional immunosuppressive therapy in severe Behcet’s Uveitis: the switch rate to the biological agents |
| title_sort | conventional immunosuppressive therapy in severe behcet s uveitis the switch rate to the biological agents |
| topic | Anti-TNF-α therapy Behçet’s uveitis Immunosuppressive therapy Interferon therapy Uveitis |
| url | http://link.springer.com/article/10.1186/s12886-018-0929-5 |
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