Article Text

other Versions

PDF
Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis: a retrospective, multicentre study in Korea
  1. Hyun Sun Jeon1,
  2. Joon Young Hyon1,
  3. Mee Kum Kim2,
  4. Tae-Young Chung3,
  5. Kyung Chul Yoon4,
  6. Jae Yong Kim5,
  7. Kyung-Sun Na6,
  8. Hyung Joon Kim7,
  9. Tae-Im Kim8,
  10. Jong Soo Lee9,
  11. Hyung Keun Lee10,
  12. Jong Suk Song11
  1. 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  2. 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
  3. 3Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  4. 4Department of Ophthalmology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
  5. 5Department of Ophthalmology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea
  6. 6Department of Ophthalmology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea
  7. 7Department of Ophthalmology, Catholic University of Daegu School of Medicine, Daegu Catholic Hospital, Daegu, Korea
  8. 8Department of Ophthalmology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
  9. 9Department of Ophthalmology, Pusan National University College of Medicine, Pusan National University Hospital & Medical Research Institute, Pusan, Korea
  10. 10Department of Ophthalmology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
  11. 11Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
  1. Correspondence to Dr Joon Young Hyon, Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi 463-707, Korea; jyhyon{at}snu.ac.kr

Abstract

Aim To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis.

Methods We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects.

Results CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively).

Conclusion The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.

  • Sclera and Episclera
  • Treatment Medical
  • Immunology
  • Inflammation
  • Pharmacology

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas