impact factor
logo
 

Full Papers

 

Intravenous methylprednisolone induces rapid improvement in non-infectious uveitis: a multicentre study of 112 patients


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

 

  1. Rheumatology, Hospital Galdakao-Usansolo, Galdakao, Spain.
  2. Rheumatology, Hospital de Sierrallana, Torrelavega, Spain.
  3. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  4. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  5. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  6. Rheumatology, Hospital del Mar, Barcelona, Spain.
  7. Ophthalmology, Hospital Universitario de Cruces, Bilbao, Spain.
  8. Rheumatology, Hospital Universitario Donostia, San Sebastián, Spain.
  9. Ophthalmology, Hospital Universitario Donostia, San Sebastián, Spain.
  10. Ophthalmology, Hospital Universitario de León, IBIOMED University of León, Spain.
  11. Ophthalmology, Hospital Universitario San Cecilio, Universidad de Granada, Instituto Investigación Biosanitaria Ibs Granada, Spain.
  12. Rheumatology, Hospital Universitario de Basurto, Bilbao, Spain.
  13. Rheumatology, Hospital Universitario de Gran Canaria Doctor Negrín, Gran Canaria, Spain.
  14. Rheumatology, Hospital Universitario Infanta Sofia, Madrid, Spain.
  15. Ophthalmology, Hospital Universitario Infanta Sofia, Madrid, Spain.
  16. Ophthalmology, Hospital Universitario La Fe, Valencia, Spain.
  17. Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  18. Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  19. Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  20. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  21. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  22. Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  23. Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain.
  24. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain.
  25. Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain. rblanco@humv.es

CER14092
Full Papers

purchase article

PMID: 33666160 [PubMed]

Received: 06/10/2020
Accepted : 08/02/2021
In Press: 05/03/2021

Abstract

OBJECTIVES:
Rapid control of intraocular inflammation in non-infectious uveitis (NIU) is mandatory to avoid irreversible structural and functional damage. In this study, we assessed the efficacy and safety of intravenous methylprednisolone (IVMP) pulses in the treatment of NIU.
METHODS:
A retrospective case series of 112 patients who received IVMP for the treatment of NIU, either isolated or associated with different underlying diseases, was studied. Intraocular inflammation (anterior chamber cells and vitritis) was the primary outcome measure. Secondary outcome measures were macular thickness and best corrected visual acuity (BCVA). Patients were assessed at baseline visit, and at days 2-5, 7, 15 and 30 after initiation of IVMP pulse therapy.
RESULTS:
A total of 112 patients (mean age 42±14.5 yrs) were assessed. An underlying immune-mediated disease was diagnosed in 73 patients. Inflammatory ocular patterns were panuveitis (n=68), posterior uveitis (n=30), anterior uveitis (AU) (n=12), and intermediate uveitis (n=2). Additionally, patients presented cystoid macular oedema (CME) (n=50), retinal vasculitis (n=37), and exudative retinal detachment (n=31). Therapies used before IVMP included intraocular glucocorticoids (n=4), high-dose oral systemic glucocorticoids (n=77), and conventional (n=107) or biologic (n=40) immunosuppressive drugs. IVMP dose ranged from 80 to 1,000 mg/day for 3-5 consecutive days. Improvement was observed in AU, vitritis, BCVA, CME, and retinal vasculitis. At first month evaluation, total remission was achieved in 19 patients. Side effects of IVMP were respiratory infections (n=3), uncontrolled hyperglycaemia (n=1), herpes zoster (n=1), and oral candidiasis (n=1).
CONCLUSIONS:
IVMP pulse therapy was effective and safe, and achieved rapid control of NIU.

Rheumatology Article