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Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis: a retrospective, multicentre study in Korea

 Hyun Sun Jeon  ;  Joon Young Hyon  ;  Mee Kum Kim  ;  Tae-Young Chung  ;  Kyung Chul Yoon  ;  Jae Yong Kim  ;  Kyung-Sun Na  ;  Hyung Joon Kim  ;  Tae-Im Kim  ;  Jong Soo Lee  ;  Hyung Keun Lee  ;  Jong Suk Song 
 BRITISH JOURNAL OF OPHTHALMOLOGY, Vol.100(8) : 1066-1070, 2016 
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Immunology ; Inflammation ; Pharmacology ; Sclera and Episclera ; Treatment Medical
AIM: To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis. METHODS: We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects. RESULTS: CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively). CONCLUSION: The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Lee, Hyung Keun(이형근) ORCID logo https://orcid.org/0000-0002-1123-2136
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