Department of Medicine, Clinical Hospital University of Chile, Santiago, Chile.
Ocul Immunol Inflamm. 2010 Jun;18(3):200-7. doi: 10.3109/09273941003587541.
To prospectively compare 2 immunosupressive regimens in patients with active Vogt-Koyanagi-Harada disease in spite of systemic glucocorticoid treatment.
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).
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.
Both regimens showed a good clinical efficacy, but CyA seems to be a better glucocorticoid-sparing agent than AZA.
前瞻性比较 2 种免疫抑制方案在全身糖皮质激素治疗后仍有活动性 Vogt-小柳-原田病患者中的疗效。
1998 年至 2005 年间共诊断出 44 例患者，其中 21 例患者尽管接受了糖皮质激素治疗仍出现慢性眼内炎症，将其随机分为泼尼松联合硫唑嘌呤（AZA）组（n = 12）或泼尼松联合环孢素（CyA）组（n = 9）。
在 AZA 组，Tyndall 评分从 1.21 ± 1.10 降至 0.29 ± 0.62（p <.01），视力（LogMAR）从 0.32 ± 0.35 提高至 0.09 ± 0.16（p <.001）。在 CyA 组，Tyndall 评分从 1.67 ± 1.08 降至 0.16 ± 0.51（p <.001），视力从 0.41 ± 0.40 提高至 0.25 ± 0.42（p <.001）。AZA 组患者需要的泼尼松平均剂量和总累积剂量明显高于 CyA 组，每个比较均 p <.01。
两种方案均显示出良好的临床疗效，但 CyA 似乎比 AZA 更能节省糖皮质激素。
