title: Azathioprine for ocular inflammatory diseases.
abstract: OBJECTIVE
  To evaluate treatment outcomes of azathioprine for noninfectious ocular inflammatory diseases.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Medical records of 145 patients starting azathioprine as a sole noncorticosteroid immunosuppressant at 4 tertiary uveitis services were reviewed. Main outcome measures included control of ocular inflammation, sustained control after tapering prednisone to </= 10 mg/day, and discontinuation of treatment because of side effects.
  
  
  RESULTS
  Among 145 patients (255 eyes) treated with azathioprine, 63% had uveitis, 23% had mucous membrane pemphigoid, 11% had scleritis, and 3% had other inflammatory diseases. By Kaplan-Meier analysis, 62% (95% confidence interval [CI], 50% to 74%) of patients with active disease initially gained complete inactivity of inflammation sustained over at least 28 days within 1 year of therapy, and 47% (95% CI, 37% to 58%) tapered systemic corticosteroids to </= 10 mg daily while maintaining control of inflammation within 1 year of therapy. Treatment success was most common for intermediate uveitis (90% with sustained inactivity within 1 year; 95% CI, 64% to 99%). Over the median follow-up of 230 days (interquartile range, 62 to 679 days), azathioprine was discontinued at a rate of 0.45 per person-years (/PY): 0.16/PY because of side effects, 0.10/PY because of ineffectiveness, 0.09/PY because of disease remission, and 0.10/PY because of unspecified causes.
  
  
  CONCLUSIONS
  Azathioprine was moderately effective as a single corticosteroid-sparing immunosuppressive agent in terms of control of inflammation and corticosteroid-sparing benefits, but required several months to achieve treatment goals; it seems especially useful for patients with intermediate uveitis. Treatment-limiting side effects occurred in approximately one-fourth of patients within 1 year, but typically were reversible.
authors: Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA.
authors: Sirichai
authors: S
authors: Pasadhika
authors: John H
authors: JH
authors: Kempen
authors: Craig W
authors: CW
authors: Newcomb
authors: Teresa L
authors: TL
authors: Liesegang
authors: Siddharth S
authors: SS
authors: Pujari
authors: James T
authors: JT
authors: Rosenbaum
authors: Jennifer E
authors: JE
authors: Thorne
authors: C Stephen
authors: CS
authors: Foster
authors: Douglas A
authors: DA
authors: Jabs
authors: Grace A
authors: GA
authors: Levy-Clarke
authors: Robert B
authors: RB
authors: Nussenblatt
authors: Eric B
authors: EB
authors: Suhler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D015423:Scleritis / Q000188:drug therapy*; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone