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Comparison of the Clinical Efficacy of Two Different Immunosuppressive Regimens in Patients with Chronic Vogt-Koyanagi-Harada Disease

2010; Taylor & Francis; Volume: 18; Issue: 3 Linguagem: Inglês

10.3109/09273941003587541

1744-5078

M Cuchacovich, Federica Solanes, Gonzalo Dí­az, Tomás Cermenati, Samuel Avila, Juan Verdaguer, Juan Ignacio Verdaguer, Cristián Carpentier, Juan Stopel, Basilio Rojas, Traipe Leonidas, Patricia Gallardo, Francisca Sabugo, Mario Zanoli, Guillermo Merino, Francisco Villarroel,

Ocular Infections and Treatments

Purpose: To prospectively compare 2 immunosupressive regimens in patients with active Vogt-Koyanagi-Harada disease in spite of systemic glucocorticoid treatment.Methods: Forty-four patients were diagnosed between 1998 and 2005. Twenty-one developed chronic intraocular inflammation in spite of glucocorticoid treatment and were randomized to receive either prednisone and azathioprine (AZA) (n = 12) or prednisone and cyclosporine (CyA) (n = 9).Results: In the AZA group Tyndall score decreased from 1.21 ± 1.10 to 0.29 ± 0.62 (p < .01), and visual acuity (LogMAR) improved from 0.32 ± 0.35 to 0.09 ± 0.16 (p < .001). In the CyA group Tyndall score decreased from 1.67 ± 1.08 to 0.16 ± 0.51 (p < .001), and visual acuity improved from 0.41 ± 0.40 to 0.25 ± 0.42 (p < .001). Patients in the AZA group needed a significantly higher average prednisone dose and total cumulative dose than those in the CyA group, p < .01 for each comparison.Conclusions: Both regimens showed a good clinical efficacy, but CyA seems to be a better glucocorticoid-sparing agent than AZA.