de Smet M D, Rubin B I, Whitcup S M, Lopez J S, Austin H A, Nussenblatt R B
Laboratory of Immunology, National Eye Institute, Bethesda, MD 20892.
Am J Ophthalmol. 1992 Jun 15;113(6):687-90. doi: 10.1016/s0002-9394(14)74795-6.
Ten patients with endogenous uveitis were in clinical remission attributable to treatment with cyclosporine and prednisone. After the cyclosporine dose was reduced by two thirds, these patients were randomly assigned to treatment with or without ketoconazole, a potent inhibitor of cytochrome P-450, in a double-masked placebo-controlled study. The dose was reduced over three days. During a three-month follow-up, no patients treated with ketoconazole had a relapse of uveitis, while four of six (66%) control subjects had a flare-up. Toxicity in the ketoconazole-treated group was limited to a transient decrease in glomerular filtration rate (20% from baseline) at one month in two of six (33%) patients. Renal function was stabilized by further reduction of the cyclosporine dose.
10例内因性葡萄膜炎患者经环孢素和泼尼松治疗后处于临床缓解期。在将环孢素剂量减少三分之二后，这些患者在一项双盲安慰剂对照研究中被随机分配接受或不接受酮康唑（一种细胞色素P-450强效抑制剂）治疗。剂量在三天内逐渐减少。在三个月的随访期间，接受酮康唑治疗的患者无一例葡萄膜炎复发，而6例对照受试者中有4例（66%）病情复发。酮康唑治疗组的毒性仅限于6例患者中有2例（33%）在1个月时肾小球滤过率出现短暂下降（较基线下降20%）。通过进一步减少环孢素剂量，肾功能得以稳定。
