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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.13.06 Efficacy and adverse effects of Cyclosporine A in the treatment of chronic anterior uveitis in patients with Juvenile Idiopathic Arthritis Tappeiner C., Heinz C., Heiligenhaus A.
Department of Ophthalmology, at St. Franziskus Hospital, Muenster Objective: Juvenile idiopathic arthritis (JIA) is often associated with chronic anterior uveitis. Presence of vision threatening complications may indicate immunosuppressive therapy. In this study, the experience with cyclosporine A (CsA) as mono- or combination-therapy with MTX was analyzed.
Methods: Monocenter, retrospective analysis of the clinical observations with CsA in JIA children with chronic anterior uveitis (CAU).
Results: Twelve JIA children (girls n=9, oligoarthritis n=11, seronegative polyarthritis n=1) suffering from unilateral (n=3) or bilateral (n=9) CAU were treated with systemic CsA. The mean age at onset of uveitis was 4.5 (2-7) years. In all patients, CsA was indicated by persistently active CAU despite on topical (n=12) or systemic corticosteroids (n=9), ethanercept (n=1), azathioprine (n=1) and methotrexate (n=9). Already before starting CsA, uveitis-complications (n=11), visual acuity £20/50 (n=6) were present, or ocular surgery (n=6) had been performed. The efficacy of CsA on uveitis was good in 6 patients, moderate in 2 and insufficient in another 4. Under CsA therapy, the topical (n=7) or systemic corticosteroids (n=5) could be reduced by ³50%. In only one patient, the other second line immunosuppressive drugs could be tapered off. CsA adverse effects were hirsutismus (n=2), headache (n=1) and increased creatinine level (n=1). In one patient, CsA had to be discontinued because of systemic hypertension.
Conclusions: The observations show that CsA may improve the course of chronic uveitis in JIA children and may have a steroid-sparing effect. In case of insufficient stabilization under MTX, uveitis improved with combined CsA therapy in approximately half of the children.
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