Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel.
OBJECTIVE
To provide recommendations for the use of immunosuppressive drugs in the treatment of patients with ocular inflammatory disorders.


METHODS
A 12-person panel of physicians with expertise in ophthalmologic, pediatric, and rheumatologic disease, in research, and in the use of immunosuppressive drugs in patient care.


METHODS
Published clinical study results. Recommendations were rated according to the quality and strength of available evidence.


METHODS
The panel was convened in September of 1999 and met regularly through May 2000. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus.


CONCLUSIONS
Although corticosteroids represent one of the mainstays in the management of patients with ocular inflammation, in many patients, the severity of the disease, the presence of corticosteroid side effects, or the requirement for doses of systemic corticosteroids highly likely to result in corticosteroid complications supports the rationale for immunosuppressive drugs (for example, antimetabolites, T-cell inhibitors, and alkylating agents) being used in the management of these patients. Because of the potential for side effects, treatment must be individualized and regular monitoring performed. With careful use of immunosuppressive drugs for treatment of ocular inflammatory disorders, many patients will benefit from them either with better control of the ocular inflammation or with a decrease in corticosteroid side effects.
Jabs
D A
DA
Wilmer Eye Institute and the Departments of Ophthalmology and Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. djabs@jhmi.edu
Rosenbaum
J T
JT
Foster
C S
CS
Holland
G N
GN
Jaffe
G J
GJ
Louie
J S
JS
Nussenblatt
R B
RB
Stiehm
E R
ER
Tessler
H
H
Van Gelder
R N
RN
Whitcup
S M
SM
Yocum
D
D
D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*
D007166:Immunosuppressive Agents