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[Classical immunosuppressive agents].

A C Martenet

    Bulletin De La Societe Belge D'Ophtalmologie
    |January 1, 1989
    PubMed
    Summary
    This summary is machine-generated.

    Immunosuppressive drugs offer therapeutic options for refractory uveitis and associated immune-mediated diseases. Effective agents include alkylating drugs and antimitotics, with careful monitoring of side effects and white blood cell counts.

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    Area of Science:

    • Ophthalmology
    • Immunology
    • Pharmacology

    Context:

    • Uveitis and associated diseases often require advanced treatment strategies beyond conventional therapies.
    • Disorders of the immune system play a significant pathogenetic role in many ocular inflammatory conditions.
    • Steroid-resistant cases necessitate exploring alternative immunomodulatory approaches.

    Purpose:

    • To evaluate the efficacy and safety of immunosuppressive and immunoregulatory drugs in managing complex uveitis cases.
    • To identify the most effective classical cytostatic drugs for uveitis treatment.
    • To establish guidelines for dosage, monitoring, and patient consent for immunosuppressive therapy.

    Summary:

    • Classical cytostatic drugs, particularly alkylating agents (chlorambucil, cyclophosphamide) and antimitotics (procarbazine, colchicine), show promise in treating uveitis.

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  • Methotrexate is also considered effective, while azathioprine appears less so.
  • Therapy requires careful patient consent, leukocyte count monitoring (4,000-5,000/mm3), and management of potential side effects like nausea and hair loss.

    • Impact:

    • Successful treatment outcomes, including inflammation resolution and functional improvement, are observed in approximately 70% of patients treated with procarbazine and cyclophosphamide.
    • Alternative treatments like cyclosporin A, plasmapheresis, or immunostimulation may be considered for treatment failures.
    • This research informs clinical practice for severe chronic uveitis, excluding acute iritis and chorioretinitis.