Pulse IV cyclophosphamide in ocular inflammatory disease: efficacy and short-term safety.
OBJECTIVE
To assess the efficacy and short-term safety of appropriately monitored pulse IV cyclophosphamide therapy in the treatment of patients with severe or treatment-resistant autoimmune ocular inflammatory disease.


METHODS
Retrospective noncomparative interventional case series.


METHODS
Thirty-eight patients with severe or recalcitrant ocular inflammation of diverse etiologies.


METHODS
Charts of patients seen on the Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary were reviewed. Thirty-eight consecutive patients treated with pulse IV cyclophosphamide between January 1995 and March 2002 were analyzed.


METHODS
The control of inflammation, steroid-sparing effect, visual acuity, and adverse reactions.


RESULTS
A positive response to treatment occurred in 68% of patients during the study period, with 55% achieving complete quiescence. A steroid-sparing effect was achieved in all patients previously on systemic steroid, allowing successful discontinuation of the drug in 41%. Visual acuity was maintained in 66% and improved in 21% of involved eyes. The most common side effects observed were fatigue (63%), nausea (32%), and headache (22%). None required a permanent discontinuation of therapy.


CONCLUSIONS
Pulse IV cyclophosphamide is an effective therapeutic modality in patients with severe or treatment-resistant ocular inflammatory disease.
Durrani
Khayyam
K
Immunology & Uveitis Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts 02114, USA.
Papaliodis
George N
GN
Foster
C Stephen
CS
D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D004341:Drug Evaluation; D005128:Eye Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007249:Inflammation / Q000188:drug therapy; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide