Effects of Taclorimus (FK506) on VKH Syndrome

Abstract

Abstract: : Purpose: Taclorimus (FK506) is known as a potent immunosuppressive agent using successfully in liver and renal transplantation. The efficacy of tacrolimus for the treatment of posterior uveitis refractory to cyclosporine A (CsA) was already reported. The purpose of this study was to assess the efficacy of taclorimus in the treatment of the uveitis with Vogt-Koyanagi-Harada (VKH) syndrome. Methods: Six patients of VKH syndrome with uveitis were studied. Clinical courses of each patient were retrospectively summarized by hospital charts. The dosage of taclorimus was adjusted according to symptoms at less than 0.15mg/kg/day. Laboratory examinations included the renal function and trough levels of taclorimus were performed once a month. Results: In five patients who had been treated previously with steroid, taclorimus was introduced in order to discontinue steroid because of side effects and rebounded reaction. Taclorimus was available for suppressing the inflammation and rebounded reaction. In one case taclorimus was introduced as the first choice of agent. Although the relapses evoked in the chronic stage of the disease, inflammation was suppressed by increasing the dose and eventually taclorimus was successfully discontinued. Renal toxicity was observed in two cases as a side effect of the therapy but they recovered after discontinuance of the treatment without irreversible damage. Conclusion: Taclorimus has a useful role as an immunosuppressive agent for the treatment of uveitis with VKH syndrome.

Keywords: 611 uvea • 357 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 437 inflammation