Department of Ophthalmology, Cerrahpaşa Medical Faculty Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Behçet's Disease Research Center, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Rheumatol Int. 2023 Nov;43(11):2099-2106. doi: 10.1007/s00296-023-05420-4. Epub 2023 Aug 17.
Experience with mycophenolate in uveitis due to Behçet syndrome (BS) is limited. Twelve patients with panuveitis or posterior uveitis who were started mycophenolate were included. Data on demographic characteristics, therapies, ocular attacks, and adverse events were extracted from patient charts. Seven patients with BS uveitis were prescribed mycophenolate for remission induction, of which 6 were refractory/intolerant to conventional immunosuppressives. Mycophenolate was combined with anti-TNFs in 3 patients, resulting in no further ocular attacks. Mycophenolate had to be stopped in the fourth patient due to adverse events. The remaining 3 patients continued to have ocular attacks and were switched to other agents without any drop in visual acuity. Among the 5 patients who were prescribed mycophenolate for maintenance, 2 were relapse free, but 3 experienced ocular attacks. One patient had an exacerbation of mucocutaneous lesions, and 2 experienced adverse events. Mycophenolate monotherapy may not be adequate for remission induction of refractory BS uveitis, but it can be a safe and effective alternative when combined with a biologic agent. It may also be an option for maintenance therapy.
有关贝赫切特综合征（BS）相关性葡萄膜炎使用霉酚酸酯的经验有限。纳入了 12 例出现全葡萄膜炎或后葡萄膜炎的患者，这些患者开始接受霉酚酸酯治疗。从患者病历中提取了人口统计学特征、治疗、眼部发作和不良反应的数据。7 例 BS 葡萄膜炎患者使用霉酚酸酯诱导缓解，其中 6 例对传统免疫抑制剂有耐药性/不耐受性。3 例患者霉酚酸酯联合抗 TNF 治疗，没有进一步的眼部发作。第 4 例患者因不良反应而停止使用霉酚酸酯。其余 3 例患者继续出现眼部发作，在不影响视力的情况下改用其他药物。在 5 例接受霉酚酸酯维持治疗的患者中，2 例无复发，但 3 例出现眼部发作。1 例患者黏膜皮肤病变加重，2 例出现不良反应。霉酚酸酯单药治疗可能不足以诱导耐药性 BS 葡萄膜炎的缓解，但当与生物制剂联合使用时，它可能是一种安全有效的替代药物。它也可能是维持治疗的选择。
