阳离子 0.1%环孢素在眼部移植物抗宿主病中的耐受性和依从性。
Tolerance and Adherence to Cationic 0.1% Cyclosporine in Ocular Graft-versus-Host Disease.
机构信息
Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Division of Dry-Eye and Ocular GvHD, University of Cologne, Cologne, Germany.
出版信息
Ophthalmic Res. 2021;64(1):77-84. doi: 10.1159/000509034. Epub 2020 May 29.
INTRODUCTION
Anti-inflammatory, topical therapy of severe keratitis in dry eye disease (DED) and ocular graft-versus-host disease (oGvHD) includes steroids, cyclosporine (Cs), and others. In Germany, a commercial product containing 0.1% Cs in a cationic formulation is available since 2015.
OBJECTIVE
The aim of this study was to present real-life data using cationic 0.1% Cs in oGvHD patients.
METHODS
This was a retrospective study of 26 oGvHD and 41 DED patients with corneal staining of at least Oxford grade III. Parameters analyzed were Ocular Surface Disease Index, corneal staining, intraocular pressure, tear film break-up time, Schirmer, and visual acuity. In addition, it was evaluated how different Cs formulations were tolerated.
RESULTS
Corneal staining improved significantly in 1 eye in DED but not in oGvHD. In DED, cationic 0.1% Cs was not tolerated by 32% of the patients, in contrast to 0.05% Cs in castor oil not tolerated by 47% and liposomal 0.05% Cs by 63%. In oGvHD patients, cationic 0.1% Cs was not tolerated by 62%, 0.05% Cs in castor oil by 33%, and liposomal 0.05% Cs by 39% of the patients.
CONCLUSIONS
This study demonstrates differences between the tolerance of different Cs formulations depending on the underlying cause of severe keratitis. Cationic 0.1% Cs is considerably less tolerated in oGvHD, and its use should be considered with care.
简介
在干燥性角结膜炎（DED）和眼移植物抗宿主病（oGvHD）的重度角膜炎的抗炎、局部治疗中，包括皮质类固醇、环孢素（Cs）和其他药物。自 2015 年以来，德国有一种商业化的产品，其中含有 0.1%的 Cs，呈阳离子制剂。
目的
本研究旨在介绍阳离子 0.1%Cs 在 oGvHD 患者中的真实数据。
方法
这是一项回顾性研究，共纳入 26 例 oGvHD 和 41 例 DED 患者，他们的角膜染色至少为牛津分级 III 级。分析的参数包括眼表面疾病指数、角膜染色、眼内压、泪膜破裂时间、泪液分泌和视力。此外，还评估了不同 Cs 制剂的耐受性。
结果
DED 中有 1 只眼的角膜染色显著改善，但 oGvHD 中没有。在 DED 中，32%的患者不能耐受阳离子 0.1%Cs，而在 castor 油中的 0.05%Cs 不能耐受的患者比例为 47%，liposomal 0.05%Cs 不能耐受的患者比例为 63%。在 oGvHD 患者中，阳离子 0.1%Cs 不能耐受的患者比例为 62%，castor 油中的 0.05%Cs 不能耐受的患者比例为 33%，liposomal 0.05%Cs 不能耐受的患者比例为 39%。
结论
本研究表明，不同 Cs 制剂的耐受性因重度角膜炎的潜在病因而异。阳离子 0.1%Cs 在 oGvHD 中的耐受性较差，应谨慎使用。
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