Cyclosporin-A therapy in severe uveitis of Behçet's disease

Cyclosporine-A (CSA) combined with corticosteroid therapy was administered to 12 patients with severe Behçet's uveitis who were resistant to colchicine or cytotoxic therapy.

Previous colchicine or cytotoxic therapies were tapered off one month before CSA therapy. All patients were started on an initial oral dose of 5 mg/kg/day of CSA. After the first three months, the CSA dose was reduced to a maintenance dose according to the intraocular inflammatory response.

The average follow-up period was 20 (12-36) months. Visual acuity remained the same in 12 (%54.5) and improved in 8 (%36.4) eyes. There was a decrease in the frequency (p<0.01) and severity (p<0.01) of ocular attacks and in the maintenance steroid dose (p<0.01) when compared with conventional therapy. The frequent side effects were paraesthesia-hyperesthesia, fatigue, nausea, hirsutism and dose-related nephrotoxicity in one patient.

The results of the study suggest that low dose CSA combined with low dose corticosteroid may be an effective therapeutic alternative in the treatment of severe refractory Behçet's uveitis.