Outcomes of early and late immunomodulatory treatment in patients with HLA-B27-associated chronic uveitis

Abstract

Immunomodulatory therapy is an effective treatment for severe HLA-B27 uveitis that fails to respond to conventional steroid treatment, regardless of the timing of its initiation. However, introduction of IMT within 3 years of the disease onset prevents the adverse effects of steroids (cataract, glaucoma) and reduces the likelihood of repeated recurrences of the uveitis.

Posterior Segment Involvement in Korean Patients with HLA-B27-Associated Uveitis

“…Conversely, Power et al 8 reported that 18% of HLA-B27-associated uveitis patients required systemic IMT. Furthermore, Androudi et al 7 reported outcomes of IMT in 72 HLA-B27-associated chronic uveitis patients, showing that IMT achieved a high rate of control of inflammation and a steroid-sparing effect. In the current study, 38.9% of patients with posterior involvement and 8.3% of patients with anterior uveitis underwent IMT.…”

“…2,7,8 Whether HLA-B27-associated uveitis shows different prognosis from HLA-B27-negative anterior uveitis is still controversial. [8][9][10][11][12][13] Although acute anterior uveitis is the typical manifestation in HLA-B27-associated uveitis, posterior segment involvement in the form of vitritis, cystoid macular edema (CME), and retinal vasculitis may develop as well.…”

Uveitis and glaucoma

“…Immunomodulatory therapy should be considered in severe uveitis to replace or reduce the dose of corticosteroids required. These include T-cell inhibitors, alkylating agents, antimetabolites, and more recently, biologic response modifiers, such as tumor necrosis factor-a inhibitors and antilymphocyte agents (Androudi et al, 2003;Bom et al, 2001;Dick et al, 1997;Foeldvari et al, 2007;Larkin and Lightman, 1999;Okada, 2005;Saurenmann et al, 2006).…”

HLA-B27-associated uveitis: From pathogenesis to therapy

“…Эти препараты могут применяться как в виде монотерапии, так и в сочетании с низкими дозами ГК [63,70,71].…”