What are the indications for aggressive immunosuppression therapy in human leukocyte antigen (HLA) B27–associated acute anterior uveitis (AAU)?

Updated: Oct 30, 2018
  • Author: Anna Luisa Di Lorenzo, MBBCh; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

More potent immunosuppression may be required in patients with vision-threatening inflammation interfering with activities of daily living, lack of response to corticosteroid treatment, and intolerance of corticosteroids. Patients taking 10 mg or more to control their symptoms may benefit from an antimetabolite as a safer long-term treatment. Drugs used in these situations include azathioprine, mycophenolate mofetil, cyclophosphamide, chlorambucil, methotrexate, tacrolimus, and cyclosporine. These agents typically are used in posterior uveitis or panuveitis, but they occasionally can be required in severe fibrinous anterior uveitis associated with reactive arthritis or ankylosing spondylitis. [13]


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