Short-term chlorambucil for refractory uveitis in Behcet's disease

Abstract

Aim: To evaluate the effects of short-term chlorambucil therapy in the management of uveitis due to Behcet's disease. Methods: Forty-four patients with refractory uveitis associated with Behcet's disease who had had short-term chlorambucil therapy for about 23 weeks were included in the study. The frequency of attacks (number of attacks per year) and the longest period between the attacks were analyzed to evaluate the efficiency of the therapy. The therapy was judged to be effective if the patient had =1 attack a year and/or =1 year between the attacks. Results: The mean follow-up time was 51.4 ± 32.5 months (range: 13–122 months). Following the therapy, the mean frequency of attacks had decreased from 4.9 ± 2.3 to 0.9 ± 1.4 (p < 0.0001) and the mean longest period between the attacks was prolonged from 4.4 ± 2.3 months to 25.7 ± 23.1 months (p < 0.0001). The ratio of severe attacks had decreased from 74.1 ± 34% to 51.3 ± 36.6% (p = 0.0218). The best-corrected visual acuity was increased in 32.9%, decreased in 34.2%, and the same in 32.9% of the eyes. Phytsis bulbi developed in three (3.8%) eyes. New attacks were seen in 56.8% of patients and another immunosuppressive agent(s) was given to 40.9% of the patients 1–8 months after treatment. No serious side effects were observed during the chlorambucil therapy. Conclusion: Short-term chlorambucil therapy for refractory uveitis in Behcet's disease is effective in controlling the disease in two-thirds of patients.