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

Detalhes bibliográficos
Autor(a) principal: Zaghetto,Juliana Marques
Data de Publicação: 2010
Outros Autores: Yamamoto,Mirian Mina, Souza,Murilo Barreto, Silva,Felipe Theodoro Bezerra Gaspar Carvalho da, Hirata,Carlos Eduardo, Olivalves,Edilberto, Yamamoto,Joyce Hisae
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos brasileiros de oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492010000100007
Resumo: PURPOSE: To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. METHODS: 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. RESULTS: 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 <0.1, among which 69% (11/16) had already this visual acuity at the first visit. CONCLUSION: 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.
id CBO-2_0138d59626b366017b2536f7e2651d1b
oai_identifier_str oai:scielo:S0004-27492010000100007
network_acronym_str CBO-2
network_name_str Arquivos brasileiros de oftalmologia (Online)
repository_id_str
spelling Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective studyBehçet syndromeImmunosuppressive agents/therapeutic useChlorambucil/therapeutic useCyclosporine/therapeutic useUveitis/therapyRetrospective studiesPURPOSE: To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. METHODS: 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. RESULTS: 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 <0.1, among which 69% (11/16) had already this visual acuity at the first visit. CONCLUSION: 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.Conselho Brasileiro de Oftalmologia2010-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492010000100007Arquivos Brasileiros de Oftalmologia v.73 n.1 2010reponame:Arquivos brasileiros de oftalmologia (Online)instname:Conselho Brasileiro de Oftalmologia (CBO)instacron:CBO10.1590/S0004-27492010000100007info:eu-repo/semantics/openAccessZaghetto,Juliana MarquesYamamoto,Mirian MinaSouza,Murilo BarretoSilva,Felipe Theodoro Bezerra Gaspar Carvalho daHirata,Carlos EduardoOlivalves,EdilbertoYamamoto,Joyce Hisaeeng2010-05-06T00:00:00Zoai:scielo:S0004-27492010000100007Revistahttp://aboonline.org.br/https://old.scielo.br/oai/scielo-oai.phpaboonline@cbo.com.br||abo@cbo.com.br1678-29250004-2749opendoar:2010-05-06T00:00Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)false
dc.title.none.fl_str_mv Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
title Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
spellingShingle Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
Zaghetto,Juliana Marques
Behçet syndrome
Immunosuppressive agents/therapeutic use
Chlorambucil/therapeutic use
Cyclosporine/therapeutic use
Uveitis/therapy
Retrospective studies
title_short Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
title_full Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
title_fullStr Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
title_full_unstemmed Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
title_sort Chlorambucil and cyclosporine A in Brazilian patients with Behçet's disease uveitis: a retrospective study
author Zaghetto,Juliana Marques
author_facet Zaghetto,Juliana Marques
Yamamoto,Mirian Mina
Souza,Murilo Barreto
Silva,Felipe Theodoro Bezerra Gaspar Carvalho da
Hirata,Carlos Eduardo
Olivalves,Edilberto
Yamamoto,Joyce Hisae
author_role author
author2 Yamamoto,Mirian Mina
Souza,Murilo Barreto
Silva,Felipe Theodoro Bezerra Gaspar Carvalho da
Hirata,Carlos Eduardo
Olivalves,Edilberto
Yamamoto,Joyce Hisae
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Zaghetto,Juliana Marques
Yamamoto,Mirian Mina
Souza,Murilo Barreto
Silva,Felipe Theodoro Bezerra Gaspar Carvalho da
Hirata,Carlos Eduardo
Olivalves,Edilberto
Yamamoto,Joyce Hisae
dc.subject.por.fl_str_mv Behçet syndrome
Immunosuppressive agents/therapeutic use
Chlorambucil/therapeutic use
Cyclosporine/therapeutic use
Uveitis/therapy
Retrospective studies
topic Behçet syndrome
Immunosuppressive agents/therapeutic use
Chlorambucil/therapeutic use
Cyclosporine/therapeutic use
Uveitis/therapy
Retrospective studies
description PURPOSE: To assess the efficacy and side effects of immunosuppressive therapy in patients with Behçet's disease uveitis. METHODS: 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. RESULTS: 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 <0.1, among which 69% (11/16) had already this visual acuity at the first visit. CONCLUSION: 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.
publishDate 2010
dc.date.none.fl_str_mv 2010-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492010000100007
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492010000100007
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0004-27492010000100007
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
dc.source.none.fl_str_mv Arquivos Brasileiros de Oftalmologia v.73 n.1 2010
reponame:Arquivos brasileiros de oftalmologia (Online)
instname:Conselho Brasileiro de Oftalmologia (CBO)
instacron:CBO
instname_str Conselho Brasileiro de Oftalmologia (CBO)
instacron_str CBO
institution CBO
reponame_str Arquivos brasileiros de oftalmologia (Online)
collection Arquivos brasileiros de oftalmologia (Online)
repository.name.fl_str_mv Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)
repository.mail.fl_str_mv aboonline@cbo.com.br||abo@cbo.com.br
_version_ 1754209026331115520