幼年特发性关节炎相关性葡萄膜炎免疫调节治疗停药后复发。
Relapse of Juvenile Idiopathic Arthritis-Associated Uveitis after Discontinuation of Immunomodulatory Therapy.
机构信息
a F.I. Proctor Foundation , University of California San Francisco , San Francisco , California , USA.
b Department of Ophthalmology , University of California San Francisco , San Francisco , California , USA.
出版信息
Ocul Immunol Inflamm. 2019;27(4):686-692. doi: 10.1080/09273948.2018.1424341. Epub 2018 Feb 16.
: To assess treatment outcomes in juvenile idiopathic arthritis (JIA)-associated uveitis and relapse rates upon discontinuation of immunomodulatory therapy (IMT). : Medical records of patients with JIA-associated uveitis seen at the University of Illinois at Chicago and the F.I. Proctor Foundation uveitis clinics from September 14, 1988 to January 5, 2011 were reviewed. The main outcome was time to relapse after attempting to discontinue IMT.: Of 66 patients with JIA-associated uveitis, 51 (77%) received IMT as either sole or combination therapy. Of a total of 51, 41 (80%) patients achieved corticosteroid-sparing control. Attempts were made to discontinue treatment in 19/51 (37%) patients. Of a total of 19 patients, 13 (68%) attempting to discontinue IMT relapsed, with a median time to relapse of 288 days from the time of attempted taper/discontinuation (IQR: 108-338).: Corticosteroid-sparing control of inflammation was achieved in the majority of patients; however, attempts to stop IMT were often unsuccessful. Close follow-up of patients after discontinuation of therapy is warranted.
评估幼年特发性关节炎（JIA）相关性葡萄膜炎的治疗结果和免疫调节治疗（IMT）停药后的复发率。
回顾了 1988 年 9 月 14 日至 2011 年 1 月 5 日期间在伊利诺伊大学芝加哥分校和 F.I.普罗克特基金会葡萄膜炎诊所就诊的 JIA 相关性葡萄膜炎患者的病历。主要结局是试图停止 IMT 后复发的时间。
在 66 例 JIA 相关性葡萄膜炎患者中，51 例（77%）接受了 IMT 作为单一或联合治疗。在总共 51 例患者中，41 例（80%）患者达到了皮质类固醇节约控制。在 51 例患者中，有 19 例（37%）试图停止治疗。在总共 19 例试图停止 IMT 的患者中，有 13 例（68%）复发，从尝试减量/停药开始的中位复发时间为 288 天（IQR：108-338）。
大多数患者实现了炎症的皮质类固醇节约控制；然而，停止 IMT 的尝试往往不成功。在停止治疗后，有必要对患者进行密切随访。
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