Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis: A retrospective, multicentre study in Korea

Hyun Sun Jeon, Joon Young Hyon, Mee Kum Kim, Tae Young Chung, Kyung Chul Yoon, Jae Yong Kim, Kyung Sun Na, Hyung Joon Kim, Tae Im Kim, Jong Soo Lee, Hyung Keun Lee, Jong Suk Song

Research output: Contribution to journalArticle

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Abstract

Aim: To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis. Methods: We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects. Results: CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively). Conclusion: The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.

Original languageEnglish
Pages (from-to)1066-1070
Number of pages5
JournalBritish Journal of Ophthalmology
Volume100
Issue number8
DOIs
Publication statusPublished - 2016 Aug

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Scleritis
Immunosuppressive Agents
Korea
Multicenter Studies
Retrospective Studies
Cyclophosphamide
Safety
Steroids
Mycophenolic Acid
Recurrence
Republic of Korea
Cystitis
Incidence
Azathioprine
Leukopenia
Therapeutics
Tertiary Care Centers
Methotrexate
Cyclosporine
Medical Records

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Jeon, Hyun Sun ; Hyon, Joon Young ; Kim, Mee Kum ; Chung, Tae Young ; Yoon, Kyung Chul ; Kim, Jae Yong ; Na, Kyung Sun ; Kim, Hyung Joon ; Kim, Tae Im ; Lee, Jong Soo ; Lee, Hyung Keun ; Song, Jong Suk. / Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis : A retrospective, multicentre study in Korea. In: British Journal of Ophthalmology. 2016 ; Vol. 100, No. 8. pp. 1066-1070.
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title = "Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis: A retrospective, multicentre study in Korea",
abstract = "Aim: To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis. Methods: We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects. Results: CYC group had a remission in 95.2{\%} of the patients and OISA group had in 96.3{\%}. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9{\%} vs 41.4{\%}, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively). Conclusion: The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.",
author = "Jeon, {Hyun Sun} and Hyon, {Joon Young} and Kim, {Mee Kum} and Chung, {Tae Young} and Yoon, {Kyung Chul} and Kim, {Jae Yong} and Na, {Kyung Sun} and Kim, {Hyung Joon} and Kim, {Tae Im} and Lee, {Jong Soo} and Lee, {Hyung Keun} and Song, {Jong Suk}",
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Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis : A retrospective, multicentre study in Korea. / Jeon, Hyun Sun; Hyon, Joon Young; Kim, Mee Kum; Chung, Tae Young; Yoon, Kyung Chul; Kim, Jae Yong; Na, Kyung Sun; Kim, Hyung Joon; Kim, Tae Im; Lee, Jong Soo; Lee, Hyung Keun; Song, Jong Suk.

In: British Journal of Ophthalmology, Vol. 100, No. 8, 08.2016, p. 1066-1070.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis

T2 - A retrospective, multicentre study in Korea

AU - Jeon, Hyun Sun

AU - Hyon, Joon Young

AU - Kim, Mee Kum

AU - Chung, Tae Young

AU - Yoon, Kyung Chul

AU - Kim, Jae Yong

AU - Na, Kyung Sun

AU - Kim, Hyung Joon

AU - Kim, Tae Im

AU - Lee, Jong Soo

AU - Lee, Hyung Keun

AU - Song, Jong Suk

PY - 2016/8

Y1 - 2016/8

N2 - Aim: To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis. Methods: We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects. Results: CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively). Conclusion: The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.

AB - Aim: To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis. Methods: We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects. Results: CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively). Conclusion: The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.

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U2 - 10.1136/bjophthalmol-2015-307462

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