Efficacy and safety of chlorambucil in intractable noninfectious uveitis

Miserocchi, Elisabetta; Baltatzis, Stefanos; Ekong, Anthony; Roque, Manolette R.; Foster, C. Stephen

doi:10.1016/s0161-6420(01)00864-8

Cited by 84 publications

(34 citation statements)

References 25 publications

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“…Patients #5 and #8 were also treated with a short-term course of chlorambucil before and after being treated with TNF blockers. Although long-term remission with Chlorambucil agents has been previously reported in our experience with JIA associated uveitis patients [42], two of our patients failed to respond to this immunosuppressive agent. Patients #5 and #8, before or after switching of three anti-TNF drugs, have also tried a one-year course of Chlorambucil treatment with long-term remission but flare up of the uveitis after cessation of the alkylating agent.…”

Section: Children With Juvenile Idiopathic Arthritis Associated Uveitcontrasting

confidence: 58%

Anti-CD 20 monoclonal antibody (rituximab) treatment for inflammatory ocular diseases

Miserocchi¹,

Pontikaki

Modorati³

et al. 2011

Autoimmunity Reviews

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Section: Children With Juvenile Idiopathic Arthritis Associated Uveitcontrasting

confidence: 58%

Anti-CD 20 monoclonal antibody (rituximab) treatment for inflammatory ocular diseases

Miserocchi¹,

Pontikaki

Modorati³

et al. 2011

Autoimmunity Reviews

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“…The cumulative dose ranged from 1710 to 2250 mg (18) . In more recent reports (12,22) , favorable results were observed after short-term (7 to 40 weeks), high-dosage (mean maximum daily dose of 20 mg/day, range 10-30 mg/day) courses of chlorambucil with a median follow-up of 46 months and no relevant side effects. The cumulative dose of chlorambucil ranged from 392 mg to 5200 mg with an average total dose of 1416 mg (12) .…”

Section: Discussionmentioning

confidence: 90%

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

Zaghetto¹,

Yamamoto²,

Souza³

et al. 2010

Arq. Bras. Oftalmol.

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“…33,35,45 Both CHB 15,[53][54][55][56] and CTX [57][58][59][60] had been successfully used in patients with a variety of severe or even recalcitrant ocular inflammatory diseases. However, the risk of side effects is substantially greater than that associated with alternative agents and requires very careful monitoring.…”

Section: Alkylating Agentsmentioning

confidence: 99%

Immunosuppressive Treatment of Non-infectious Uveitis: History and Current Choices

Zhao¹,

Zhang²

2017

cmsj

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Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveitis. Although systemic corticosteroids have been the gold standard of immunosuppressive treatment for uveitis since first introduced in 1950s, its side effects of long-term use often warrant an adjuvant treatment to reduce the dosage/duration of corticosteroids needed to maintain disease control. Conventional immunosuppressive drugs, classified into alkylating agent, antimetabolites and T cell inhibitors, have been widely used as corticosteroid-sparing agents, each with characteristic safety/tolerance profiles on different uveitis entities. Recently, biologic agents, which target specific molecules in immunopathogenesis of uveitis, have gained great interest as alternative treatments for refractory uveitis based on their favorable safety and effectiveness in a variety of uveitis entities. However, lack of large randomized controlled clinical trials, concerns about efficacy and safety of long-term usage, and economic burden are limiting the use of biologics in non-infectious uveitis. Local administration of immunosuppressive drugs (from corticosteroids to biologics) through intraocular drug delivery systems represent another direction for drug development and is now under intense investigation, but more evidences are needed to support their use as regular alternative treatments for uveitis. With the numerous choices belonging to different treatment modalities (conventional immunosuppressive agents, biologics and local drug delivery systems) on hand, the practice patterns have been reported to vary greatly from center to center. Factors influence uveitis specialists' choices of immunosuppressive agents may be complex and may include personal familiarity, treatment availability, safety/tolerability, effectiveness, patient compliance, cost concerns and suggestions from related specialists such as rheumatologists and pediatricians. The focus of this review is to provide an overview of each treatment modality on safety/tolerability and effectiveness, which are believed to be the two most important factors affecting treatment decision making.

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Efficacy and safety of chlorambucil in intractable noninfectious uveitis

Cited by 84 publications

References 25 publications

Anti-CD 20 monoclonal antibody (rituximab) treatment for inflammatory ocular diseases

Anti-CD 20 monoclonal antibody (rituximab) treatment for inflammatory ocular diseases

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

Immunosuppressive Treatment of Non-infectious Uveitis: History and Current Choices

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