Systemic Chemotherapy for Ocular Cicatricial Pemphigoid
Systemic Chemotherapy for Ocular Cicatricial Pemphigoid
复制标题
眼部瘢痕性类天疱疮的全身化疗
作者：
J. Tauber;Maite Sáinz de la Maza;C. Foster
回顾性分析105例眼瘢痕性类天疱疮（OCP）患者接受3种不同化疗药物治疗的临床资料，比较不同化疗方案的远期疗效、毒副反应及耐受性。对于整个组，10%的患者中6%的眼发生OCP进展（随访35个月）。超过一半的治疗失败发生在对化疗不耐受的患者中。二氨基二苯砜（DAP）作为初始药物，在2%的患者中未能控制疾病，而环磷酰胺（CYC）和硫唑嘌呤（AZA）分别为8%和9%（p < 0.05）。结果分层显示，DAP是中度活动OCP最有效的初始药物，而CYC是高度活动病例最有效的初始选择。单药治疗10个月或更长时间的患者中，4%的DAP、4%的CYC和15%的AZA患者未能控制疾病（p < 0.01）。推荐OCP的序贯化疗方法。
The records of 105 patients treated with three different chemotherapeutic agents for ocular cicatricial pemphigoid (OCP) were reviewed to compare long-term efficacies, side effects, and tolerance of different regimens. For the entire group, OCP progressed in 6% of eyes in 10% of patients (follow-up 35 months). More than half of the treatment failures occurred in patients intolerant of chemotherapy. Diaminodiphenylsulfone (DAP), as initial agent, failed to control disease in 2% of patients, compared with 8% after cyclophosphamide (CYC) and 9% after azathioprine (AZA) (p < 0.05). Stratification of results revealed that DAP was the most effective initial agent for modestly active OCP, whereas CYC was the most effective initial choice for highly active cases. In patients treated with a single agent exclusively for 10 months or more, failure to control disease occurred in 4% of DAP, 4% of CYC, and 15% of AZA patients (p < 0.01). Recommendations for a sequential approach to chemotherapy for OCP are presented.