Failure of Conventional Immunosuppressive Therapy Among Patients with Behçet Uveitis: Causes and Management Modalities
Accept poster if oral is not possible ?
Yes
Purpose
To assess the causes of failure of conventional therapy among patients with Behçet uveitis and to describe subsequent management modalities during the last decade in a referral center in Tunisia, North Africa.
Methods
Retrospective descriptive study including patients diagnosed with Behçet disease posterior uveitis according to the ICBD during the decade of 2013-2023. Excluded were patients who were lost to follow-up and those with a follow-up period <6 months
Results
101 patients were selected. The mean age was 31 years (range, 7–61). There were 78 males (77.2 %) and 23 females (22.8 %).
All patients were treated with oral corticosteroids and immunosuppressants, including Azathioprine in 97 patients (96%), Cyclosporine A in 6 patients (5.9%), and Mycophenolate Mofetil in one patient (1%).
Of 101 patients, 68 (67.3 %) achieved a sustained remission during a mean follow-up period of 4 years (range: 0.9 to 10.7 years), and 33 (32.7 %) had uncontrolled disease activity.
The underlying causes of treatment failure were medication-nonadherence in 4 patients (12.12 %), drug-induced severe anemia in one patient (3.03 %) and resistance to the treatment in 28 patients (84.85 %). The subsequent therapeutic approaches included switching to another IS (3.03 %), adding another IS in 9 patients (27.27 %), using periocular steroid injection in 10 patients (30.3 %) and switching to biologic agents in 26 patients (78.79 %).
Conclusion
The rate of failure of conventional immunosuppressive therapy among patients with Behçet uveitis was 32.7%. The main cause of failure was uncontrolled disease activity, with subsequent use of biologic agents in most cases
Conflict of interest
No
1
Last name
AHBEDDOU
Initials of first name(s)
S
Department
Ophtalmoclinic Noor
City
Rabat
Country
Morocco
2
Last name
NABI
Initials of first name(s)
W
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
3
Last name
BERBICH
Initials of first name(s)
Z
Department
Ophtalmologie B, Hopital des spécialités
City
Rabat
Country
Morocco
4
Last name
MOURALI
Initials of first name(s)
M
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
5
Last name
KHAIRALLAH
Initials of first name(s)
M
Department
Department of Ophthalmology, Fattouma Bourguiba University Hospital
City
Monastir
Country
Tunisia
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