Immunosuppressive Therapy of Ocular Inflammatory Diseases

Intravenous cyclophosphamide therapy for patients with severe ocular inflammatory diseases who failed other immunomodulatory therapies

“…Intravenous CP was first used in ophthalmic inflammation by Wong et al [ 20 ] and then also shown to be effective in Adamantiades-Behçet’s disease [ 21 ] and severe refractory uveitis [ 22 ]. It has several advantages over oral CP, including faster control of severe ocular inflammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses [ 13 ].…”

Intravenous cyclophosphamide therapy for patients with severe ocular inflammatory diseases who failed other immunomodulatory therapies

“…Intravenous CP was first used in ophthalmic inflammation by Wong et al [ 20 ] and then also shown to be effective in Adamantiades-Behçet’s disease [ 21 ] and severe refractory uveitis [ 22 ]. It has several advantages over oral CP, including faster control of severe ocular inflammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses [ 13 ].…”

Intravenous Cyclophosphamide Therapy for Patients with Severe Ocular Inflammatory Diseases Who Failed Other Immunomodulatory Therapies

“…Intravenous CP was rst used in ophthalmic in ammation by Wong et al 20 and then also shown to be effective in Adamantiades-Behçet's disease 21 and severe refractory uveitis. 22 It has several advantages over oral CP, including faster control of severe ocular in ammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses.…”

Ten-year experience of pulsed intravenous cyclophosphamide and methylprednisolone protocol (PICM protocol) in severe ocular inflammatory disease

“…Despite the advantages of a more rapid response to therapy and less associated systemic adverse events compared with the potential lag period for the oral preparation, intravenous cyclophosphamide has only been used cautiously in the management of ocular inflammatory disease with correspondingly less published data. A variety of protocols have been described with success and these include weekly intravenous cyclophosphamide in six patients with a range of inflammatory eye diseases,23 monthly dosing in patients with either Behçet's disease-associated ocular inflammation or a spectrum of uveitis types,20 24 and delivery of 3–4 weekly infusions to a heterogeneous group of patients including uveitis, Behçet's disease, rheumatoid arthritis and mucous membrane pemphigoid requiring 2–10 doses over a 14-month period 8. This series noted a positive response to treatment in 68% patients during the study period with 55% achieving complete quiescence versus our overall figures of 55% achieving a positive response (ie, complete success or partial success) and 34% achieving complete quiescence (12 months results).…”

Intravenous cyclophosphamide therapy for patients with severe ocular inflammatory diseases who failed other immunomodulatory therapies

“…Intravenous CP was first used in ophthalmic inflammation by Wong et al [ 20 ] and then also shown to be effective in Adamantiades-Behçet’s disease [ 21 ] and severe refractory uveitis [ 22 ]. It has several advantages over oral CP, including faster control of severe ocular inflammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses [ 13 ].…”

Intravenous Cyclophosphamide Therapy for Patients with Severe Ocular Inflammatory Diseases Who Failed Other Immunomodulatory Therapies

“…Intravenous CP was rst used in ophthalmic in ammation by Wong et al 20 and then also shown to be effective in Adamantiades-Behçet's disease 21 and severe refractory uveitis. 22 It has several advantages over oral CP, including faster control of severe ocular in ammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses.…”

Ten-year experience of pulsed intravenous cyclophosphamide and methylprednisolone protocol (PICM protocol) in severe ocular inflammatory disease

“…Despite the advantages of a more rapid response to therapy and less associated systemic adverse events compared with the potential lag period for the oral preparation, intravenous cyclophosphamide has only been used cautiously in the management of ocular inflammatory disease with correspondingly less published data. A variety of protocols have been described with success and these include weekly intravenous cyclophosphamide in six patients with a range of inflammatory eye diseases,23 monthly dosing in patients with either Behçet's disease-associated ocular inflammation or a spectrum of uveitis types,20 24 and delivery of 3–4 weekly infusions to a heterogeneous group of patients including uveitis, Behçet's disease, rheumatoid arthritis and mucous membrane pemphigoid requiring 2–10 doses over a 14-month period 8. This series noted a positive response to treatment in 68% patients during the study period with 55% achieving complete quiescence versus our overall figures of 55% achieving a positive response (ie, complete success or partial success) and 34% achieving complete quiescence (12 months results).…”

Intravenous cyclophosphamide therapy for patients with severe ocular inflammatory diseases who failed other immunomodulatory therapies

“…Intravenous CP was first used in ophthalmic inflammation by Wong et al [ 20 ] and then also shown to be effective in Adamantiades-Behçet’s disease [ 21 ] and severe refractory uveitis [ 22 ]. It has several advantages over oral CP, including faster control of severe ocular inflammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses [ 13 ].…”

Intravenous Cyclophosphamide Therapy for Patients with Severe Ocular Inflammatory Diseases Who Failed Other Immunomodulatory Therapies

“…Intravenous CP was rst used in ophthalmic in ammation by Wong et al 20 and then also shown to be effective in Adamantiades-Behçet's disease 21 and severe refractory uveitis. 22 It has several advantages over oral CP, including faster control of severe ocular in ammation, usually transient (rather than permanent) leukopenia, and reduced risk of toxicity (as it bypasses the bladder), enabling larger doses.…”

Ten-year experience of pulsed intravenous cyclophosphamide and methylprednisolone protocol (PICM protocol) in severe ocular inflammatory disease

“…Despite the advantages of a more rapid response to therapy and less associated systemic adverse events compared with the potential lag period for the oral preparation, intravenous cyclophosphamide has only been used cautiously in the management of ocular inflammatory disease with correspondingly less published data. A variety of protocols have been described with success and these include weekly intravenous cyclophosphamide in six patients with a range of inflammatory eye diseases,23 monthly dosing in patients with either Behçet's disease-associated ocular inflammation or a spectrum of uveitis types,20 24 and delivery of 3–4 weekly infusions to a heterogeneous group of patients including uveitis, Behçet's disease, rheumatoid arthritis and mucous membrane pemphigoid requiring 2–10 doses over a 14-month period 8. This series noted a positive response to treatment in 68% patients during the study period with 55% achieving complete quiescence versus our overall figures of 55% achieving a positive response (ie, complete success or partial success) and 34% achieving complete quiescence (12 months results).…”