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J. Schlotter, D. Boehringer, T. Ness; Efficacy of Mycophenolate Mofetil, Methotrexat and Cyclosporine for the Treatment of Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5267.
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To evaluate the efficacy and tolerance of mycophenolate mofetil (MMF), methotrexate (MTX), and cyclosporine as first immunosuppressive agent for the treatment of non-infectious uveitis.
In this retrospective case study the records of 544 patients with uveitis treated at a single academic referral center were reviewed. These data were analyzed in accordance with SUN (Standardization of Uveitis Nomenclature) recommendations. All patients included had primarily been treated with systemic steroids and reduction had failed prior to the immunosuppressive therapy. The main outcome parameters of the different immunosuppressive agents were: time of relapse free survival (a concomitant prednisolone dosage < 5 mg was allowed) and rate of discontinuation because of side effects.
137 patients were included in the study. The patients suffered from anterior, posterior or panuveitis. The mean follow-up was 2 years. The initial therapy with systemic corticosteroids was effective in about 75% of the patients. Therefore only about 25% of these patients needed an immunosuppressive therapy. There was no statistically significant difference between the three immunossuppresants. With all substances about two third of the patients achieved a prednisolone dosage of 5 mg or less without any relapse. The rate of intolerance due to side effects was low in all groups.
The primary efficacy of cyclosporine, MTX, and MMF was comparable. Since there is no difference in therapy outcome, the decision for one substance should be made with respect to the expected side effects in relation to the specific condition of the patient.
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