Conventional immunosuppressive therapy in severe Behcet's Uveitis: the switch rate to the biological agents.
Conventional immunosuppressive therapy in severe Behcet's Uveitis: the switch rate to the biological agents.
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DOI：
10.1186/s12886-018-0929-5
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发表时间：
2018-10-05
影响因子：
2
通讯作者：
Direskeneli H
中科院分区：
文献类型：
--
作者：
Celiker H;Kazokoglu H;Direskeneli H
报道难治性白塞氏葡萄膜炎（BU）患者从常规免疫抑制（CIS）治疗转向生物制剂（BA）治疗的比率。在这项回顾性研究中，我们回顾了76例接受免疫抑制药物治疗的116只眼出现BU的患者的临床记录。非正态分布参数组间比较采用Mann Whitney U检验，描述性统计方法（均数、标准差、中位数、频数、率）计算采用Mann Whitney U检验。非正态分布参数组内比较采用Wilcoxon Signed Ranks检验。定性资料比较采用Pearson卡方检验和Fisher-Freeman-Halton检验。除1例外，所有患者均首先采用CIS方案治疗布鲁里溃疡。31例（41.3%）对CIS方案无反应的患者改用IFNα2a治疗。之后，其中8例切换到抗tnf -α治疗。BA组患者的初始眼部并发症发生率高于CIS组（p < 0.001）。在CIS治疗和BA治疗的病例中，与初次检查相比，在最后一次检查中观察到视力（VA）的增加，并且具有显著性（p < 0.001和p = 0.018）。正如严重布鲁里溃疡的管理指南所建议的那样，CIS治疗是有效和安全的。生物治疗对VA的改善也有效。我们观察到58.7%的病例可以通过强免疫抑制治疗，然而，如果不存在BAs，近一半的患者可能会失去VA。在重症BU患者的治疗过程中，经典治疗阶段由于其合理的活动性和安全性，仍然必须作为一线治疗加以保护。
To report the switch rate of conventional immunosuppressive (CIS) therapies to the biological agents (BA) in patients with refractory Behcet’s uveitis (BU). In this retrospective study, clinical records were reviewed of 76 patients’ 116 eyes presenting with BU who had been treated with immunosuppressive drug therapy. Mann Whitney U test was used for the intergroup comparisons of parameters without normal distribution as well as calculation of descriptive statistical methods (mean, standard deviation, median, frequency and rate). Wilcoxon Signed Ranks test was used for the intragroup comparisons of parameters without normal distribution. Pearson’s Chi-Square test and Fisher-Freeman-Halton test were used for the comparisons of qualitative data. Except for one, all patients were first treated with CIS regimens for BU. Thirty-one patients (41.3%) who were unresponsive to CIS regimens were switched to IFNα2a therapy. After that, eight of these cases were switched to the anti-TNF-α treatments. The presence of initial ocular complications were found to be statistically higher in BA treated patients than the CIS treated cases (p < 0.001). Both in CIS treated and in BA treated cases, an increase in visual acuity (VA) was observed during the last examination compared to the initial examination and was significant (p < 0.001 and p = 0.018, respectively). CIS treatment was found to be effective and safe, as suggested in the management guidelines for severe BU. Biological therapy was also found effective for the improvement of the VA. We observed that 58.7% of cases could be treated with strong immunosuppressive therapies, however, nearly half of the patients could have lost their VA if BAs were not existent. During the treatment course of severe cases with BU, classical therapy stage must still be protected as the first-line therapy due to the their reasonable activity and safety.
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影响因子：
--
作者：
Onal, Sumru;Kazokoglu, Haluk;Yavuz, Sule
通讯作者：
Yavuz, Sule
影响因子：
13.7
作者：
Sobaci, Gungor;Erdem, Uzeyir;Bayraktar, M. Zeki
通讯作者：
Bayraktar, M. Zeki
影响因子：
3.7
作者：
Imrie, Fraser R.;Dick, Andrew D.
通讯作者：
Dick, Andrew D.
影响因子：
4.2
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Kacmaz, R. Oktay;Kempen, John H.;Newcomb, Craig;Gangaputra, Sapna;Daniel, Ebenezer;Levy-Clarke, Grace A.;Nussenblatt, Robert B.;Rosenbaum, James T.;Suhler, Eric B.;Thorne, Jennifer E.;Jabs, Douglas A.;Foster, C. Stephen
通讯作者：
Foster, C. Stephen
影响因子：
13.7
作者：
Diaz-Llopis, Manuel;Salom, David;Fernando Arevalo, J.
通讯作者：
Fernando Arevalo, J.