| Abstract | PURPOSE: To study the efficacy of tacrolimus in immune posterior uveitis. METHODS: Twenty-one eyes of 11 patients with immune posterior uveitis under tacrolimus treatment were prospectively followed for 1 to 5 years. Tacrolimus dosage was adjusted to maintain blood levels in the range of 7 to 10 ng/mL. Systemic and ophthalmic evaluations were performed at baseline and during follow-up. RESULTS: After a mean follow-up of 45 months, no treatment other than tacrolimus was necessary to control the inflammation in 6 cases (54.5%). The number of annual recurrences decreased from 3.2 to 1.29 during tacrolimus treatment (p=0.021). In four patients, tacrolimus was suspended after a treatment period of 27+/-3.5 months and a follow-up period of 12 months free of uveitis relapses. All four were free from relapses following tacrolimus withdrawal. Visual acuity remained unchanged in 16/21 (76%) eyes, deteriorated in 4/21 (19%), and improved in 1/21 (5%). Renal function transiently deteriorated in four patients from basal serum creatinine levels of 0.84, 1.1, 0.88, and 0.78 mg/dL to maximum levels of 1.33, 2.48, 1.38, and 1.39 mg/dL, respectively. This deterioration was directly related with elevated tacrolimus serum levels, returning to normal when doses were reduced. During the overall controlled evolution period, a slight increase of serum creatinine from a basal value of 0.89+/-0.2 mg/dL to a final of 1+/-0.19 mg/dL was detected, which was not statistically significant. All secondary effects were mild, transient, and did not require interruption of long-term treatment to be controlled. CONCLUSIONS: Tacrolimus was well tolerated and useful in controlling posterior immune uveitis. Tacrolimus could be considered a real alternative to cyclosporine, and not only in cases of cyclosporine resistance or toxicity. |
| Authors | M S Figueroa, E Ciancas, L Orte
(Affiliation: Department of Ophthalmology, Hospital Universitario Ramon y Cajal, Madrid and Vissum Madrid, Spain. figueroa at servicon2000.com)
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| Journal | European journal of ophthalmology
(Eur J Ophthalmol)
2007 Jan-Feb
Vol. 17
Issue 1
Pg. 69-74
ISSN: 1120-6721 Italy |
| PMID | 17294385
(Publication Type: Journal Article)
|
| Chemical References |
- Immunosuppressive Agents
- Tacrolimus
- Creatinine
|
| Topics |
- Adult
- Biological Availability
- Creatinine
(blood)
- Female
- Follow-Up Studies
- Humans
- Immunosuppressive Agents
(pharmacokinetics, therapeutic use)
- Male
- Middle Aged
- Prospective Studies
- Recurrence
- Tacrolimus
(pharmacokinetics, therapeutic use)
- Treatment Outcome
- Uveitis, Posterior
(drug therapy, immunology, metabolism)
- Visual Acuity
|
