Low-dose-corticosteroids as Long-term Monotherapy - Sufficient Immunosupression in Patients with Chronic Uveitis?
Mackensen F.1, Fiehn C.2, Becker M. D.1
Interdisziplinäres Uveitiszentrum, 1Universitäts-Augenklinik, 2Medizinische Klinik V und Poliklinik, Universität Heidelberg
Purpose: Low dose systemic corticosteroids (insufficient to induce iatrogenic Cushing syndrome) are well-tolerated and often used as a monotherapy for rheumatoid arthritis and sarcoidosis to avoid other systemic immunosuppressive treatment. The aim of this study was to identify a subgroup of patients with chronic uveitis that could be treated with low dose systemic corticosteroids alone.
Method: We included consecutive patients attending the Interdisciplinary Uveitis Center Heidelberg from April 2001 to March 2003 that met the following criteria: previous successful treatment with a tapering regimen of prednisone; and relapse after complete cessation. The next cycle of systemic prednisone treatment was tapered down until dosage was below or equal 10 mg prednisone per day without relapse of disease for at least 60 days.
Results: A total of 20 patients (14 female and 6 male) were included with a median age of 44 years (range 31-81 years). Side-effects were not observed. Systemic associations were found in 12 patients: 6 patients were diagnosed with sarcoidosis, 2 with psoriasis, one with colitis ulcerosa, one had autoimmune hepatitis, one with Lyme disease and one with multiple sclerosis. After a median observation per
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