The Use of Low-Dose Azathioprine in Patients with Vogt-Koyanagi-Harada Disease

Abstract

Purpose: To evaluate treatment outcomes with low-dose azathioprine in Vogt-Koyanagi-Harada (VKH) disease patients. Design: Retrospective case series. Methods: Medical records of consecutive patients with VKH disease were reviewed. Azathioprine was administered in cases with corticosteroid intolerance or uncontrolled inflammation. Corticosteroid sparing effect, visual acuity, corticosteroid dose, and complication rates were evaluated. Results: Sixteen of 34 VKH patients included in this study underwent azathioprine therapy with systemic corticosteroid. Six patients received azathioprine in the acute uveitic phase and 10 patients in the chronic recurrent phase. A corticosteroid sparing effect was achieved in 86.5% of patients given azathioprine in the acute uveitic phase and 90.0% of patients given in the chronic recurrent phase. Median time to corticosteroid sparing effect was 3.5 months. Twelve of 16 patients showed improved activity in 1 month after initiation of azathioprine therapy. Conclusion: Low-dose azathioprine therapy may be effective as corticosteroid sparing agent in VKH disease.

KEYWORDS:

• Azathioprine
• immunomodulatory therapy
• uveitis
• Vogt-Koyanagi-Harada disease