Impact of Initial Management on Disease Evolution in Vogt–Koyanagi–Harada Syndrome: A Retrospective Cohort of 50 Patients

ABSTRACT

Purpose

The study aims to determine the impact of initial management in Vogt–Koyanagi–Harada syndrome (VKHS).

Methods

Patients diagnosed with a VKHS between January 2001 and December 2020 in two French tertiary centers were included in a retrospective study.

Results

Fifty patients were included with a median duration of follow-up of 29.8 months. All patients received oral prednisone after methylprednisolone in all but four of them. Five patients received at least one associated immunosuppressive therapy (IST) within the first 6 months and 26 patients received IST during the entire follow-up period. Twenty-eight patients presented at least one relapse at a median of 5.4 months from diagnosis. Multivariate analyses demonstrated a significant association between relapse and delayed treatment (>26 days) (HR = 3.69, CI95% 1.30–10.47, p = .01), whereas no association was observed between relapse and the number of corticosteroid pulses at initial management.

Conclusion

An early corticosteroid treatment within the first 26 days of symptoms decreased the relapse rate.

KEYWORDS:

• Corticosteroids
• immunosuppressive therapy
• management
• relapse
• Vogt–Koyanagi–Harada

Ethics statement

Our manuscript was written following the STROBE guidelines. Opinion of the Ethical committee was not required for this retrospective observational study. Patients gave their consent to the use and collect of their clinical data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contribution

All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Dr Fauquier had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study conception and design. AF, CAD, TB, BT, AB, PS, PB, DM and AH.

Acquisition of data. AF, TB, CAD, SE.

Analysis and interpretation of data. AF, TB, CAD.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.