Therapeutic Approaches in Vogt-Koyanagi-Harada Disease: Findings from a Large Argentinian Cohort
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Purpose
To evaluate the treatment profile of patients with Vogt-Koyanagi-Harada (VKH) disease at the "Hospital de Clínicas José de San Martín" in Buenos Aires, Argentina, between 1984 and 2021, focusing on conventional and biological immunosuppressive therapies.
Methods
A retrospective cohort study analyzed 178 VKH patients. Data on demographics, disease stage at presentation and last visit, and administered treatments were collected. Statistical analyses included chi-square tests and odds ratio calculations.
Results
Among 178 patients (145 women, 33 men; mean age 36.7 ± 14.62 years), 54 were in the acute stage and 124 in the chronic stage at diagnosis. At the last visit, 35 patients remained in the acute stage, 19 were in remission, and 124 were in the chronic stage. Immunosuppressive treatment was given to 124 patients. Frequently used agents included azathioprine (32), methotrexate (11), chlorambucil (25), and mycophenolate mofetil (5). Sequential therapy with combinations of these agents was observed in 26 patients, and 27 required biological therapies. The mean cumulative duration of inflammatory activity was 34.53 ± 54.25 months.
Statistical Analysis: A significant association was found between prolonged inflammatory activity and biological treatment (p < 0.001). Patients with over 52 weeks of inflammation had an odds ratio of 5.824 (95% CI: 3.023–11.218) for requiring biologics.
Conclusion
Most patients presented and remained in the chronic stage. Conventional therapies, especially azathioprine and methotrexate, were commonly used, though biologics played a crucial role for prolonged inflammation. Intensive management is essential to achieve disease control, particularly in chronic cases.
Conflict of interest
No
1
Last name
COMASTRI
Initials of first name(s)
L
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
Buenos Aires
Country
Argentina
2
Last name
Montoya
Initials of first name(s)
J
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
3
Last name
Heredia
Initials of first name(s)
M
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
4
Last name
Romano
Initials of first name(s)
J
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
5
Last name
Couto
Initials of first name(s)
C
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
6
Last name
Gomez
Initials of first name(s)
R
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
7
Last name
Schlaen
Initials of first name(s)
A
Department
Uveitis section department of Ophthalmology, Hospital de Clinicas Jose de San Martin
City
BUENOS AIRES
Country
Argentina
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