Azathioprine as a treatment option for uveitis in patients with juvenile idiopathic arthritis
Résumé
Aim: To investigate the therapeutic value of azathioprine as monotherapy or combined with other immunosuppressive drugs for uveitis in patients with juvenile idiopathic arthritis (JIA). Methods: Retrospective multi-center study including 41 JIA children (28 (68.2%) female) with unilateral or bilateral (n=28) chronic anterior uveitis. Azathioprine was used to treat uveitis that was active in patients on topical or systemic corticosteroids, MTX, or other immunosuppressive drugs. The primary endpoint was assessment of uveitis inactivity. Secondary endpoints comprised dose sparing of topical steroids and systemic corticosteroids and immunosuppression. Results: At 1 year, uveitis inactivity was achieved in 13/17 (76.5%) of patients by using azathioprine as systemic monotherapy and in 5/9 (56.6%) as combination therapy. During the entire azathioprine treatment period (mean 26 months), inactivity was obtained in 16/26 patients (61.5%) with monotherapy and in 10/15 (66.7%) when combined with other immunosuppressives (p=1.0). With azathioprine, dosages of systemic immunosuppression and steroids could be reduced by ≥50% (n=12) or topical steroids reduced to ≤2 drops/eye/day in 6 patients. In 3 patients (7.3%), azathioprine was discontinued because of nausea and stomach pain. Conclusions: “Azathioprine may be reconsidered in the step-ladder approach for the treatment of JIA-associated uveitis. The addition of azathioprine may also be beneficial for patients not responding properly to methotrexate.”
Origine : Fichiers produits par l'(les) auteur(s)
Loading...