A Clinical Trial Comparing the Safety and Efficacy of Topical Tacrolimus versus Methylprednisolone in Ocular Graft-versus-Host Disease

Abud, Tulio Batista; Amparo, Francisco; Saboo, Ujwala S.; Zazzo, Antonio Di; Dohlman, Thomas H.; Ciolino, Joseph B.; Hamrah, Pedram; Dana, Reza

doi:10.1016/j.ophtha.2016.02.044

Cited by 61 publications

(46 citation statements)

References 37 publications

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“…A Phase I/II prospective, randomized, double-blind study showed that topical tacrolimus .05% was safe, well tolerated, and effective for ocular GVHD without the hypertensive effects of topical corticosteroids [91]. Topical .02% tacrolimus ointment also has exhibited rapid anti-inflammatory effects in patients with ocular GVHD, which allows a reduction of steroid use in the long term [92].…”

Section: Decrease In Ocular Surface Inflammationmentioning

confidence: 99%

Ocular Graft-versus-Host Disease after Hematopoietic Cell Transplantation: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation

Inamoto¹,

Valdés-Sanz

Ogawa

et al. 2019

Biology of Blood and Marrow Transplantation

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A B S T R A C T Ocular graft-versus-host disease (GVHD) occurs in more than one-half of patients who develop chronic GVHD after allogeneic hematopoietic cell transplantation (HCT), causing prolonged morbidity that affects activities of daily living and quality of life. Here we provide an expert review of ocular GVHD in a collaboration between transplantation physicians and ophthalmologists through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. Recent updates in ocular GVHD regarding pathophysiology, preclinical models, risk factors, prevention, screening, diagnosis, response criteria, evaluation measures, and treatment are discussed. Ocular GVHD involves at least 3 biological processes: lacrimal gland dysfunction, meibomian gland dysfunction, and corneoconjunctival inflammation. Preclinical models have identified several novel pathogenic mechanisms, including the renin angiotensin system and endoplasmic reticulum stress signaling, which can be targeted by therapeutic agents. Numerous studies have identified reliable tests for establishing diagnosis and response assessment of ocular GVHD. The efficacy of systemic and topical treatment for ocular GVHD is summarized. It is important that all health professionals caring for HCT recipients have adequate knowledge of ocular GVHD to provide optimal care.

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Section: Decrease In Ocular Surface Inflammationmentioning

confidence: 99%

Ocular Graft-versus-Host Disease after Hematopoietic Cell Transplantation: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation

Inamoto¹,

Valdés-Sanz

Ogawa

et al. 2019

Biology of Blood and Marrow Transplantation

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“…In general, ancillary therapies should be maximized to reduce the need for systemic immunosuppression. While systemic absorption from topical therapies is rare, all patients, and in particular very young children, must be monitored for evidence of toxicity (Abud et al, ; Albuquerque et al, ; Brown, Edwards, Walsh‐Chocolaad, & Childs, ; Carpenter et al, ).…”

Section: Management Of Cgvhdmentioning

confidence: 99%

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

et al. 2018

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Chronic GVHD is a serious disease which may be active for years, or even decades, requiring potentially years of immunosuppressive therapies and placing patients at risk for a number of late complications. While the oral cavity has long been recognized to be a prominent target of GVHD, and in particular, chronic GVHD, it must be recognized and appreciated that it is a complex systemic disease with a wide spectrum of clinical manifestations.

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“…[9899] Furthermore, because of its potent immunosuppressive effects, tacrolimus has been used in various studies to prevent graft rejection in HR hosts as detailed below.…”

Section: Systemic Therapymentioning

confidence: 99%

Systemic immunomodulatory strategies in high-risk corneal transplantation

Abud¹,

Zazzo²,

Kheirkhah³

et al. 2017

J Ophthalmic Vis Res

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The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

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A Clinical Trial Comparing the Safety and Efficacy of Topical Tacrolimus versus Methylprednisolone in Ocular Graft-versus-Host Disease

Cited by 61 publications

References 37 publications

Chronic graft‐versus‐host disease: Current management paradigm and future perspectives

Systemic immunomodulatory strategies in high-risk corneal transplantation

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