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The efficacy of sirolimus in the treatment of patients with refractory uveitis

机译:西罗莫司治疗难治性葡萄膜炎的疗效

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>Aims: To determine the efficacy of sirolimus in the treatment of patients with severe non-infectious uveitis.>Methods: Eight patients with severe non-infectious uveitis were recruited to an open study. Inclusion criteria were limited to patients whose disease was not controlled with at least two or more separate steroid sparing immunosuppressants (either because of unacceptable side effects or ineffectiveness of the drug) or who required regular doses of corticosteroids either as high dose systemic or orbital floor injections in order to control their disease. Intraocular inflammation, visual acuity, symptoms, corticosteroid burden, drug toxicity, and side effects were monitored.>Results: Sirolimus therapy was effective in five of the eight patients, all of whom had their dose of corticosteroids reduced or discontinued. Treatment in three patients was considered a failure as it caused intolerable side effects and/or failed to control the uveitis. Side effects were common and were typically gastrointestinal or cutaneous in nature. The severity of symptoms was dose dependent in most cases and occurred at trough blood levels above 25 ng/ml.>Conclusion: Sirolimus is an effective and potent immunosuppressive treatment in the majority of patients with non-infectious uveitis and can reduce the need for long term supplementary corticosteroid therapy. Further studies are required to establish the long term efficacy and safety of sirolimus alone or in combination with other steroid sparing immunosupressants.
机译:>目的::确定西罗莫司治疗重度非感染性葡萄膜炎的疗效。>方法:招募八名重度非感染性葡萄膜炎患者进行开放研究。入选标准限于以下疾病的患者:未使用至少两种或更多种单独的类固醇保护性免疫抑制剂(由于不良的副作用或药物无效)无法控制疾病,或需要常规剂量的皮质类固醇作为大剂量全身或眼底注射为了控制自己的病。监测眼内炎症,视敏度,症状,皮质类固醇负担,药物毒性和副作用。>结果:西罗莫司治疗8例患者中有5例有效,所有患者的皮质类固醇激素剂量降低或降低。已停产。三例患者的治疗被认为是失败的,因为它引起了无法忍受的副作用和/或未能控制葡萄膜炎。副作用很常见,本质上通常是胃肠道或皮肤副作用。在大多数情况下,症状的严重程度与剂量有关,并且发生在血液浓度高于25 ng / ml的情况下。>结论:西罗莫司是大多数非感染性葡萄膜炎患者的有效且有效的免疫抑制治疗方法,可以减少长期补充皮质类固醇激素治疗的需要。需要进一步研究以确立西罗莫司单独或与其他不使用类固醇的免疫抑制剂联用的长期疗效和安全性。

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