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Efficacy of Adalimumab with dose -reduced glucocorticoid for the treatment of Vogt-Koyanagi-Harada disease
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- Author:
- No author available
- Journal Title:
- International Eye Science
- Issue:
- 12
- DOI:
- 10.3980/j.issn.1672-5123.2022.12.26
- Key Word:
- 阿达木单抗;肿瘤坏死因子-α;Vogt-小柳原田综合征;糖皮质激素;疗效
Abstract： 目的:评估阿达木单抗(ADA)及糖皮质激素减量治疗Vogt-小柳原田综合征(VKH综合征)的临床疗效.方法:纳入2020-08/2021-12在我院眼科接受ADA治疗的VKH综合征患者21例37眼,眼内炎症控制并持续3mo后逐步延长ADA给药间隔,如炎症复发则恢复为初始治疗间隔.随访12mo,比较首次注射ADA治疗前后前房细胞(ACC)等级、玻璃体混浊(VH)等级、视网膜/脉络膜炎、浆液性视网膜脱离(SRD)、最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、糖皮质激素及免疫抑制剂使用剂量,记录治疗失败事件和不良反应.结果:与基线相比,治疗后2wk,1、3、6mo,纳入患者ACC等级≤1+、VH等级≤1+的患眼比例提高(P<0.05),伴视网膜/脉络膜炎的患眼比例明显降低(P<0.01),BCVA和CMT均显著改善(P<0.01),糖皮质激素平均用量明显减少(P<0.01).终末随访时82％的患者糖皮质激素用量≤5mg,所有患者均停止使用免疫抑制剂.随访期间发生治疗失败事件13次,延长ADA治疗间隔的患者12例(57％),未发现与ADA治疗相关的严重不良事件.结论:ADA治疗VKH综合征具有良好的疗效,能够减少糖皮质激素和免疫抑制剂的用量,延长ADA治疗间隔是有效的,且复发率较低.
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