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Thomas Sales De Gauzy, Fanny Varenne, vincent soler, Bahram Bodaghi, Priscille OLLE, DAMIEN BIOTTI; Impact of immunomodulatory and immunosuppressive treatments on recurrence of multiple sclerosis-related uveitis.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5349.
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© ARVO (1962-2015); The Authors (2016-present)
Few data are available regarding the optimal treatment of multiple sclerosis (MS)-related uveitis.The aim of this study is to evaluate the impact of multiple sclerosis (MS) treatment and conventional immunosuppressive therapies on the recurrence rate of uveitis associated with MS.
We conducted a retrospective, bicentric observational study of all patients with MS with at least one uveitis in two centres (May 2010-May 2019). Exclusion criteria were other cause of uveitis and follow-up less than 12 months. Treatment were divided into three groups : group 1 (first-line MS treatment ): interferon β, glatiramer acetate, dimethyl-fumarate, teriflunomide; group 2 ( second-line MS treament except fingolimod because of risk of macular edema) : natalizumab, anti-CD20 ; group 3 (conventional immunosuppressive therapies) : azathioprine, mycophenolate mofetil, methotrexate, cyclophosphamide. The primary endpoint was the number of ocular attacks per year during treatment compared to the pre-treatment period for each treament group, each patient was his or her own control. Characteristics of uveitis and treatment were reviewed.
Forty-four patients were included. Patients were followed for 7,91 years (mean) before treament versus 2,92 years during treatment. Typically, uveitis was bilateral (77%), chronic (68%) and intermediate (80%). Cystoid macular edema occured in 13 patients (30%). Besides local treatment, uveitis was managed with systemic steroids (57%), intravitreal steroids (14%) and immunosuppressants (25%). Twenty-four patients received at least one treatment of group 1, 17 of group 2 and 14 of group 3. The frequency of ocular attacks per year decreased in the 3 groups during the treatment period from 0.82 ± 1.07 to 0.12 ± 0.36 in group 1; from 0.77 ± 0.52 to 0.09 ± 0.34 in group 2; from 1.58 ± 2.36 to 0.14 ± 0.27 in group 3 (all p <0.05).
MS treatment, excluding fingolimod, are associated with a decrease in frequency of uveitis recurrence. These results are reassuring for their use in patients with uveitis and support a potential combined neurological and ocular effect.
This is a 2020 ARVO Annual Meeting abstract.
Mean frequency of ocular attacks per year before treatment (white bar) and during treatment (black bar) in groups 1, 2 and 3. Error bars show standard deviations. *Significant difference P < 0.05.
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