The effect of sulfasalazine on the course of recurrent anterior uveitis: a three-year follow-up.
Purpose
To evaluate the efficacy of sulfasalazine (SSZ) for recurrent acute anterior uveitis (AAU).
Methods
Retrospective chart review of patients diagnosed with recurrent AAU treated with SSZ from January 2008 to March 2023. The grading of uveitis activity was defined as per SUN working group. The major outcome was the reduction in the number of uveitis flare-ups over a one-year and three year-period, compared to pretreatment year. The response criteria of SSZ were defined as normal ophthalmologic examination. Paired samples Wilcoxon test and Kaplan-Meier survival curve were calculated using SPSS statistical software (p<0.05).
Results
Forty patients were included (males=21; 52.5%). Mean time of follow up was 46.57 months (range 0.5-288, SD=54.75). In 62.5% of cases (n=25) uveitis was bilateral, non-simultaneous. Three patients developed adverse effects to SSZ (7.5%). Seven patients (17.5%) had to interrupt SSZ due to clinical inefficacy. Ankylosing spondylitis was the most frequent association (n=23, 57.5%). HLA-B27 was positive in 65% (n=26). The most frequent indication for SSZ was based on ocular activity in 47.5% (n=19). The mean number of flare-ups in the pretreatment year was 1.9 (SD=1.3), at one year 0.75 (SD=1.16) with statistical significance (p<0.001), and at third year 0.76 (SD=0.89) with statistical significance (p=0.021). The mean time to flare-up of AAU after SSZ was 32.8 months (IC 95%, Range 16.7-49.0).
Conclusion
We suggest sulfasalazine as an effective treatment to reduce flare-ups in patients with recurrent non-infectious AAU. Its low cost and high safety profile make it an interesting therapeutic alternative, especially in women of childbearing age.
Conflict of interest
No
Authors 1
Last name
AVELLO GOROSTIDI
Initials of first name(s)
A
Department
Ophthalmology
City
Valdemoro
Country
Spain
Authors 2
Last name
HERNANZ RODRIGUEZ
Initials of first name(s)
I
Department
Ophthalmology - Ocular inflammation and uveitis
City
Madrid
Country
Spain
Authors 3
Last name
CARREÑO SALAS
Initials of first name(s)
E
Department
Ophthalmology - Ocular inflammation and uveitis
City
Madrid
Country
Spain
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