Comparison of the clinical efficacy of two different immunosuppressive regimens in patients with chronic vogt-koyanagi-harada disease.
OBJECTIVE
To prospectively compare 2 immunosupressive regimens in patients with active Vogt-Koyanagi-Harada disease in spite of systemic glucocorticoid treatment.


METHODS
Forty-four patients were diagnosed between 1998 and 2005. Twenty-one developed chronic intraocular inflammation in spite of glucocorticoid treatment and were randomized to receive either prednisone and azathioprine (AZA) (n = 12) or prednisone and cyclosporine (CyA) (n = 9).


RESULTS
In the AZA group Tyndall score decreased from 1.21 +/- 1.10 to 0.29 +/- 0.62 (p < .01), and visual acuity (LogMAR) improved from 0.32 +/- 0.35 to 0.09 +/- 0.16 (p < .001). In the CyA group Tyndall score decreased from 1.67 +/- 1.08 to 0.16 +/- 0.51 (p < .001), and visual acuity improved from 0.41 +/- 0.40 to 0.25 +/- 0.42 (p < .001). Patients in the AZA group needed a significantly higher average prednisone dose and total cumulative dose than those in the CyA group, p < .01 for each comparison.


CONCLUSIONS
Both regimens showed a good clinical efficacy, but CyA seems to be a better glucocorticoid-sparing agent than AZA.
Cuchacovich
Miguel
M
Department of Medicine, Clinical Hospital University of Chile, Santiago, Chile. mcuchacovich@reclinicauchile.cl
Solanes
Federica
F
Díaz
Gonzalo
G
Cermenati
Tomás
T
Avila
Samuel
S
Verdaguer
Juan
J
Verdaguer
Juan Ignacio
JI
Carpentier
Cristian
C
Stopel
Juan
J
Rojas
Basilio
B
Traipe
Leonidas
L
Gallardo
Patricia
P
Sabugo
Francisca
F
Zanoli
Mario
M
Merino
Guillermo
G
Villarroel
Francisco
F
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome; D014607:Uveomeningoencephalitic Syndrome / Q000188:drug therapy*; D014792:Visual Acuity; D055815:Young Adult
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone