[Comparative study of the treatment of autoimmune uveitis with prednisone and with cyclophosphamide and azathioprine].
BACKGROUND
Uveitis is considered an autoimmune disease that compromises any internal structure of eye; its main characteristic is the inflammatory process inside eye.


OBJECTIVE
To determine which is the most effective therapy for autoimmune uveitis: cyclophosphamide, azathioprine and prednisone.


METHODS
Patients between 16 and 65 years old, both sexes, with diagnosis of autoimmune uveitis (anterior, intermediate and posterior). Patients were submitted to clinical history, physical exploration and clinical studies. Their written informed consent was requested and patients were divided into three treatment groups: group 1 (azathioprine) 14 (42.4%) patients; group 2 (prednisone) 15 (45.5%) patients, and group 3 (cyclophosphamide) 4 (12.1%) patients. Blind double observations and assessments at day 0 and at week 1, 2, 4 and 6 of treatment were performed.


RESULTS
Out of 33 patients studied, 13 (39.4%) were male and 20 (60.6%) female, the most frequent diagnosis was uveitis due to Toxoplasmosis. With azathioprine 100 mg/day it was observed a better and faster control of inflammation after 6.2 weeks at anterior chamber with p < 0.0001, with prednisone, p = .000, and with cyclophosphamide, p = 135. In the posterior chamber there were no significant inflammatory changes for three groups with p = .353. The most frequent adverse effects occurred in the prednisone group with p < 0.05 in 24.2%, characterized by neutropenia and urinary tract infection.


CONCLUSIONS
Azathioprine, 100 mg/day oral during six weeks, is considered the most effective drug, since it demonstrated significant diminishment of inflammatory process in less time, with less side effects and with conservation of visual acuity.
Flores
M
M
Servicio de oftalmología, Hospital de Especialidades, CMN Siglo XXI, IMSS.
Gudiño Pérez
R
R
Ríos Prado
R
R
Almedia Arvizu
V M
VM
Castrejón Vázquez
M I
MI
Ocampo
A A
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000188:drug therapy*; D001379:Azathioprine / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D014605:Uveitis / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone