AB0571 High Dose Intravenous Methylprednisolone Induces RAPID Improvement in Severe Ocular Inflammation. Multicenter Study of 104 Cases

  1. Beltrán-Catalán, E. 1
  2. Calvo-Río, V. 2
  3. Blanco-Alonso, R. 2
  4. Ortego Centeno, N. 3
  5. García Serrano, J.L. 4
  6. Martinez-Costa Pérez, L. 5
  7. Fonollosa Calduch, A. 6
  8. Hernandez Garfella, M. 7
  9. Valls, E. 5
  10. Francisco Hernández, F. 8
  11. Reyes, M.A. 9
  12. Torre, I. 10
  13. Maíz, O. 11
  14. Blanco, A. 11
  15. Muñoz-Fernández, S. 8
  16. Esteban, M.D.M. 12
  17. Pato-Cour, E. 15
  18. Diaz, M. 14
  19. Gallego, R. 14
  20. Cordero-Coma, M. 13
  21. Ortiz, F. 2
  22. Cañal, J. 2
  23. González-Gay, M.A. 2
  1. 1 Hospital General Universitario de Valencia
    info

    Hospital General Universitario de Valencia

    Valencia, España

    ROR https://ror.org/03sz8rb35

  2. 2 Hospital Universitario Marqués de Valdecilla
    info

    Hospital Universitario Marqués de Valdecilla

    Santander, España

    ROR https://ror.org/01w4yqf75

  3. 3 Unidad de Enfermedades Autoinmunes
  4. 4 Hospital Universitario San Cecilio
    info

    Hospital Universitario San Cecilio

    Granada, España

  5. 5 Hospital Universitario Doctor Peset
    info

    Hospital Universitario Doctor Peset

    Valencia, España

    ROR https://ror.org/03971n288

  6. 6 Hospital de Cruces
    info

    Hospital de Cruces

    Barakaldo, España

    ROR https://ror.org/03nzegx43

  7. 7 Servicio de Oftalmología, Hospital General Universitario
  8. 8 Servicio de Reumatología
  9. 9 Hospital de Gran Canaria Dr. Negrin
    info

    Hospital de Gran Canaria Dr. Negrin

    Las Palmas de Gran Canaria, España

    ROR https://ror.org/00s4vhs88

  10. 10 Hospital Universitario de Basurto
    info

    Hospital Universitario de Basurto

    Bilbao, España

    ROR https://ror.org/00j4pze04

  11. 11 Hospital Universitario de Donostia
    info

    Hospital Universitario de Donostia

    San Sebastián, España

    ROR https://ror.org/04fkwzm96

  12. 12 Hospital Infanta Sofia
    info

    Hospital Infanta Sofia

    Madrid, España

    ROR https://ror.org/05dfzd836

  13. 13 Servicio de Oftalmología, Hospital de Leόn
  14. 14 Hospital Universitario La Fe
    info

    Hospital Universitario La Fe

    Valencia, España

    ROR https://ror.org/01ar2v535

  15. 15 Servicio de Reumatología, Hospital Clínico San Carlos, Madrid
Mostrar afiliaciones +
Revista:
Annals of the Rheumatic Diseases

ISSN: 0003-4967,  1468-2060

Año de publicación: 2014

Volumen: 73

Número: Suppl 2

Páginas: 995.1-995

Tipo: Artículo

DOI: 10.1136/ANNRHEUMDIS-2014-EULAR.4735 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Annals of the Rheumatic Diseases

Resumen

Background Intense ocular inflammation can cause an early and irreversible structural and functional damage.Objectives Treatment with high-dose intravenous methylprednisolone (IVMP) can induce a rapid improvement in multiple inflammatory conditions including uveitis.Methods A multicenter study of 104 patients (169 eyes) with severe ocular inflammation treated with IVMP attended in uveitis units of 11 hospitals. The most frequent underlying syndromes were: idiopathic uveitis (n=21), Vogt-Koyanagi-Harada (n=26), Behçet (n=19), spondyloarthritis (n=4), Sjögren syndrome (n=2), psoriatic arthritis (n=2) and multiple Sclerosis (n=2). The patients were evaluated at baseline and on days 2-5, 7, 15 and 30 after treatment with IVMP.Results 104 patients (59 women/45 men) were studied with a mean age of 42.27±14.42 years (range 8-76 years) receiving doses of IVMP, which ranged from 0.25 to 1 gram per day for 2-5 consecutive days. They all had active and severe intraocular inflammation at baseline. The inflammatory ocular patterns were: panuveitis (n=61), posterior uveitis (n=35), anterior uveitis (n=3), scleritis (n=3) and intermediate uveitis (n=2). Bilateral ocular involvement was observed in 65 patients (62.5%). After IVMP treatment, the inflammation of the anterior chamber, the vitritis and visual acuity experienced rapid and statistically significant improvement from the second day. However, the improvement of retinal vasculitis, choroiditis/chorio-retinitis and macular edema was more slowly achieved, gaining statistical significance from the first week. Optical coherence tomography (OCT) showed a macular thickening (>250μ) in 90 eyes at baseline, with normalization in 30% of affected eyes at day 15 and in 50% of affected eyes at day 30 (p<0.05). IVMP therapy was well tolerated and no notable side effects were reported.Conclusions Our study suggests that IVMP is an effective and safe remission induction therapy in severe ocular inflammation.