依那西普治疗复发性Behcet病葡萄膜炎的短期疗效和安全性研究

目的 探讨依那西普治疗复发性Behcet病(BD)葡萄膜炎的短期疗效和安全性.方法 回顾性病例研究.对2007年4月至2008年6月期间在北京协和医院眼科与风湿免疫科门诊随诊的12例(16只眼)复发性BD葡萄膜炎患者给予依那西普治疗.在糖皮质激素与免疫抑制剂治疗基础上,采用依那西普25 mg溶于1 ml注射用水皮下注射,初始频率为每周2次,根据疗效和患者经济状况减为每周1次.用药前及每次随诊检查裸眼视力、眼压、眼前节、眼底情况,必要时行彩色眼底照相、荧光素眼底血管造影、眼部B超等检查.观察终点为眼部炎症反应明显好转或因各种原因停药.结果 12例患者中,9例至少有单眼视力改善,3例视力无明显改善.16只眼中,10只眼(63%)治疗后视力改善,6只眼(37%)视力同治疗前,无视力减退眼;7只眼(44%)视力提高≥2行.所有患者眼前、后节炎症反应均明显好转或基本消退.所有患者在治疗期间均没有出现严重不良反应.结论 在糖皮质激素与免疫抑制剂治疗的基础上,依那西普治疗复发性BD葡萄膜炎具有较好的短期疗效和安全性.

The short-term efficacy and safety treatment study of recurrent uveitis in Behcet disease with etanercept

Objective To investigate the short-term efficacy and safety of etanercept for recurrent Behcet disease (BD).Methods Retrospective review of 12 recurrent BD uveitis patients (16 eyes)who were followed up in Department of Ophthalmology and Department of Rheumatology of Peking Union Medical College Hospital during April 2007 to June 2008 and received etanercept for treatment of uveitis.On the basis of conventional corticosteroid and immunosuppressive therapy,subcutaneous injection of 25 mg etanercept twice per week was instituted initially,followed by a tapering to once per week based on efficacy and economic consideration. Complete ocular examination including visual acuity,intraocuiar pressure,anterior segment and fundus conditions were well documented at base line and at each visit.Fundus photography,fluorescein angiography,ocular B ultrasound were conducted when necessary.Endpoint of observation:substantial improvement of ocular inflammation or etanercept treatment was stopped for various reasons.Results Of 12 patients,9 had shown improvement on visual acuity at least in one eye,although 3 of them did not show improvement.At end point,as compared to base line,of 16 eyes,10(63%)had better visual aeuity,6 (37%)had the same visual acuity,and none decreased;substantial improvement or remission of both anterior and posterior segment inflammation were observed for all patients.No serious adverse reaction was observed during follow up. Conclusion On the basis of corticosteroid and immunosuppressive therapy,etanercept has good short term efficacy and safety for recurrent BD uveitis.