Cyclosporin a in the Treatment of Severe Behçet’s Uveitis

Binder, Allan; Graham, Elizabeth; Sanders, Michael; Dinning, W.J.; James, David G.; Denman, A. M.

doi:10.1093/rheumatology/26.4.285

Cited by 67 publications

(14 citation statements)

References 13 publications

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“…It has been shown in so many studies that flare and cells of vitreous decrease within the first few weeks of therapy, while retinal vasculitis needs a longer period of time for improvement (Mü ftü oglu et al 1987;Binder et al 1987). Withcup et al (1994) have shown that, in comparison to CSA alone, combined CSA with steroid treatment has been successfully effective in improvement of visual acuity within the first three months of treatment, but there were no significant differences in overall visual acuity of two groups in a long term period.…”

Section: Discussionmentioning

confidence: 99%

Cyclosporin‐A therapy in severe uveitis of Behçet's disease

Süllü

Öge

Erkan

et al. 1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: Cyclosporine-A (CSA) combined with corticosteroid therapy was administered to 12 patients with severe Behçet's uveitis who were resistant to colchicine or cytotoxic therapy. Methods: Previous colchicine or cytotoxic therapies were tapered off one month before CSA therapy. All patients were started on an initial oral dose of 5 mg/ kg/day of CSA. After the first three months, the CSA dose was reduced to a maintenance dose according to the intraocular inflammatory response. Results: The average follow-up period was 20 (12-36) months. Visual acuity remained the same in 12 (%54.5) and improved in 8 (%36.4) eyes. There was a decrease in the frequency (p∞0.01) and severity (p∞0.01) of ocular attacks and in the maintenance steroid dose (p∞0.01) when compared with conventional therapy. The frequent side effects were paraesthesia-hyperesthesia, fatigue, nausea, hirsutism and dose-related nephrotoxicity in one patient. Conclusion:The results of the study suggest that low dose CSA combined with low dose corticosteroid may be an effective therapeutic alternative in the treatment of severe refractory Behçet's uveitis.

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Section: Discussionmentioning

confidence: 99%

Cyclosporin‐A therapy in severe uveitis of Behçet's disease

Süllü

Öge

Erkan

et al. 1998

Acta Ophthalmologica Scandinavica

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“…CsA is a fungal cyclic undecapeptide that has been shown to be effective both in organ transplantation [15] and in many autoimmunue disorders such as Behcet's syndrome [2,4], psoriasis [8] and rheumatoid arthritis [6]. CsA like FK506 acts by inhibiting IL2 and IL2R production and the early stages of Tlymphocyte activation.…”

Section: Discussionmentioning

confidence: 99%

Long-term cyclosporine treatment in a group of severe myasthenia gravis patients

Bonifati

Angelini

1997

Journal of Neurology

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We evaluated cyclosporine A (CsA) treatment in 9 patients (6 female and 3 male), 16-63 years old, with severe myasthenia gravis (MG) for a mean period of 2 years (range 16-36 months). All of the patients had been previously treated either with corticosteroids or by combined immunotherapy, and 5 needed periodic plasma exchanges. The reduction of plasmapheresis cycles in the 5 patients who needed periodic plasma exchange to maintain an acceptable quality of life showed an impressive cost-benefit analysis. During CsA treatment 7 of 9 patients improved their muscle strength and functional score. In all the patients except one the corticosteroid dosage was reduced and in 7 of the 9 patients the dose reduction was over 50% with subsequent reduction of the corticosteroid side effects. The findings showed that initiation of CsA treatment increased muscle strength and reduced corticosteroid dosage. The most common CsA side effects were: a serum creatinine increase that occurred in the first 6-12 months of therapy in 8 patients, other side effects like hypertrichosis and gingival hyperplasia were present in four patients. Blood pressure increase was found in only one patient. CsA treatment may be a valuable and cost effective treatment in severe MG.

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“…In this open clinical trial, intermittent, low-dose cyclosporine was found to abrogate the intraocular inflammation. Improvement in clinical findings may occur within three to five days in experimental studies and within one to two weeks in clinical trials [21][22][23]. In this study, we found out that exacerbations were frequent in patients with Behcet's disease.…”

Section: Discussionmentioning

confidence: 53%

Cyclosporine effects on optic nerve and retinal vasculitis in Behcet's disease

1992

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In a prospective, open clinical trial, we studied long-term effects of cyclosporine (CsA) on the optic nerve and retinal vasculitis in 14 Behçet's disease patients. Patients were treated with CsA and corticosteroids for a mean period of 42 months, with a range of 36 to 52 months. They received an initial CsA dosage of 7 mg/kg/day for three days, followed by 5 mg/kg/day, and prednisone 1 mg/kg/day for three to five days, tapered to 0.4 mg/kg/day. CsA was tapered when clinical response was noted. Improvement occurred in visual acuity and visual field defects secondary to papillitis, optic neuritis, macular neuroretinitis, and retinal phlebitis, but not with retinal arteritis. Despite a 12/14 (85%) exacerbation rate, no permanent liver or renal lab tests abnormalities were noted. Intermittent, low-dose CsA therapy may be considered in treatment of acute retinal and optic nerve vasculitis assisted with Behçet's disease.

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Cyclosporin a in the Treatment of Severe Behçet’s Uveitis

Cited by 67 publications

References 13 publications

Cyclosporin‐A therapy in severe uveitis of Behçet's disease

Cyclosporin‐A therapy in severe uveitis of Behçet's disease

Long-term cyclosporine treatment in a group of severe myasthenia gravis patients

Cyclosporine effects on optic nerve and retinal vasculitis in Behcet's disease

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