Abstract
Abstract: :
Purpose: We report the outcomes of oral non–steroidal anti–inflammatory drug (NSAID) therapy as a treatment for HLA–B27 positive patients who suffer from recurrent, non infectious uveitis. These patients had a desire to be weaned off chronic steroid use. Methods: Retrospective clinical analysis. Inclusion criteria: 133 patients, Human Leukocyte Antigen (HLA) B27 positive, with recurrent, noninfectious uveitis. Exclusion critera: Missing data, loss to followup, poor historian (n = 55); comorbidity with infectious component, scleritis or multiple sclerosis (n = 11); former or concurrrent use of immunomodulatory therapy (IMT) or therapeutic pars plana vitrectomy (PPV) (n = 10); no specific treatment recommended (n = 14). A final group of 43 patients (86 eyes) were identified and the following factors were summarized: pre–treatment rate of flareups, type of treatment(s) used, post–treatment rate of flareups, ability to limit use of steroids to acute attacks. The mean frequency of the pre–treatment and post–treatment flareups were then averaged and compared. Results: n = 43 patients (86 eyes) were reviewed. Females: n = 18; Males n = 25. Average age: 41 years (range of ages: 9 to 84 years). Pre–NSAID treatment average attack rate: 1 attack every 12.8 months; Post–NSAID treatment average attack rate: 1 attack every 38.3 months. Patients off chronic steroid therapy: 100%. Side effects primarily encompassed gastric upset (n = 5), which was alleviated by changing the type of oral NSAID prescribed. Conclusions: In comparing pre–NSAID treatment attack rates to post–NSAID treatment attack rates, there is a greater than 66.8% reduction in attack incidences once the patients were on NSAID therapy. These patients were also able to limit the use of steroids (oral, topical or depot) to acute attacks. We conclude that in a select population of patients with chronic, recurrent HLA–B27 associated non–infectious uveitis, oral NSAIDs offer a reasonable approach to controlling the rates of recurrence that is common to this disease entity.
Keywords: inflammation • uvea • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled