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R. Kacmaz, J. H. Kempen, C. Newcomb, R. B. Nussenblatt, J. T. Rosenbaum, E. B. Suhler, J. E. Thorne, D. A. Jabs, G. A. Levy-Clarke, C. Foster; Clinical Outcomes of Ocular Inflammatory Disease Patients Treated With Cyclosporine-A as a Single Immunomodulatory Agent. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2699.
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To evaluate the clinical outcomes of cyclosporine-A used as a single immunomodulatory agent for non-infectious ocular inflammation
444 consecutive patients with non-infectious ocular inflammation started on cyclosporine as a single immunomodulatory agent at five ocular inflammation subspecialty centers between 1979-2007 were included. Demographic and clinical characteristics, including dosage of cyclosporine-A and main outcome measures (control of inflammation, corticosteroid-sparing effects, incidence of and reason for discontinuation of therapy) were obtained for every eye of every patient at every visit by medical record review.
Of the 444 patients (819 eyes with ocular inflammation) observed to start cyclosporine-A monotherapy, 16.7%, 30.5%, 47.3%, 2.8%, and 2.6% respectively had anterior uveitis, intermediate uveitis,posterior/panuveitis, scleritis, and other forms of ocular inflammation. Within these groups, complete suppression of inflammation sustained for ≥28 days was achieved in ≤6 months in 29.2%, 29.2%, 23.7%, 62.3%, and 20% respectively. Corticosteroid-sparing success (controlled inflammation with prednisone ≤10 mg/day for ≥28 days) was achieved within 6 months among 27.5%, 18.7%, 14.1%, 52.8%, and 20% of the respective groups. However, results were substantially better using less stringent sucsess criteria. Cyclosporine-A was discontinued within ≤1 year by 210 (47%) patients. Side effects were the cause of discontinuation in 50 patients (11%), and typically were reversible with dose reduction/discontinuation.
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