Sharon Yael, Chu David S
Metropolitan Eye Research and Surgery Institute, Palisades Park, NJ, USA.
Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
Am J Ophthalmol Case Rep. 2019 Jun 22;15:100502. doi: 10.1016/j.ajoc.2019.100502. eCollection 2019 Sep.
To describe the potential role of adrenocorticotropic hormone (ACTH) gel treatment in patients with chronic non-infectious uveitis.
We report the clinical course of three patients with bilateral, non-infectious anterior and intermediate uveitis, treated with ACTH gel for ≥12 months. All three patients had chronic and steroid-dependent ocular inflammation with subsequent development of ocular complications. Twice-weekly treatment with subcutaneous 80 unit/day ACTH gel was administered, and clinical outcome measures were observed. After a mean period of 14 months, all patients demonstrated significant improvement in disease activity, stable visual acuity, and an absence of side effects. Systemic steroids dosage was successfully reduced from a mean dose of 16 mg/day upon the initiation of ACTH gel treatment to 2 mg/day at last follow up.
Subcutaneous ACTH gel has shown to be a safe and effective therapy in the management of non-infectious uveitis. Specifically, ACTH gel plays a role in refractory and steroid-dependent cases and in those who do not respond to or are unable to tolerate other immunomodulatory therapies.
描述促肾上腺皮质激素(ACTH)凝胶治疗慢性非感染性葡萄膜炎患者的潜在作用。
我们报告了3例双侧非感染性前葡萄膜炎和中间葡萄膜炎患者接受ACTH凝胶治疗≥12个月的临床过程。所有3例患者均患有慢性且依赖类固醇的眼部炎症,并随后出现眼部并发症。给予皮下注射80单位/天的ACTH凝胶,每周2次,并观察临床结局指标。平均14个月后,所有患者的疾病活动度均有显著改善,视力稳定,且无副作用。全身类固醇剂量已成功从ACTH凝胶治疗开始时的平均剂量16毫克/天降至最后一次随访时的2毫克/天。
皮下注射ACTH凝胶已被证明是治疗非感染性葡萄膜炎的一种安全有效的疗法。具体而言,ACTH凝胶在难治性和依赖类固醇的病例以及那些对其他免疫调节疗法无反应或无法耐受的病例中发挥作用。