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Purpose <p>To evaluate the efficacy of sulfasalazine (SSZ) for recurrent acute anterior uveitis (AAU).</p> Methods <p>Retrospective&#xa0;chart&#xa0;review of&#xa0;patients&#xa0;diagnosed with&#xa0;recurrent AAU treated with SSZ&#xa0;from&#xa0;January&#xa0;2008 to&#xa0;September 2023. The&#xa0;grading of&#xa0;uveitis&#xa0;activity&#xa0;was&#xa0;defined as&#xa0;per SUN&#xa0;working&#xa0;group. The primary outcome was the&#xa0;reduction&#xa0;in the&#xa0;number of&#xa0;uveitis&#xa0;flare-ups&#xa0;over a one-year, two-year and three year-period,&#xa0;compared&#xa0;to pre-treatment year.&#xa0;The response criteria&#xa0;to SSZ&#xa0;were defined as normal ophthalmologic examination. Paired samples Wilcoxon test and Kaplan–Meier&#xa0;survival curve&#xa0;were&#xa0;calculated using R-Commander statistical software (<i>p</i> &lt; 0.05).</p> Results <p>Fifty-three patients were included. Mean time of follow up was 38.51 ± 38.45&#xa0;months.&#xa0;Nine patients developed adverse effects to SSZ (16.98%) most of them mild. Ankylosing&#xa0;spondylitis was the most frequent association&#xa0;(n = 28,&#xa0;52.83%), while HLA-B27 was positive in 69.23% of the patients (n = 36). The most frequent indication for SSZ was based on ocular activity in 52.83% (n = 28). The number of flare-ups dropped from 2.25 (± 1.34) in the pre-treatment year to, 0.81&#xa0;(± 0.99) at year 1 (<i>p</i> &lt; 0.001), 0.61 (± 0.78) at year 2 (<i>p</i> &lt; 0.001) and 0.65 (± 0.83) at year 3 (<i>p</i> = 0.005).&#xa0;The median time to flare-up&#xa0;of AAU&#xa0;after SSZ&#xa0;was&#xa0;15.13&#xa0;months&#xa0;(CI 95, 7.97–27.40).</p> Conclusion <p>Our data point to sulfasalazine as an effective treatment&#xa0;to reduce flare-ups&#xa0;in patients with recurrent&#xa0;non-infectious AAU.&#xa0;Its&#xa0;low cost and&#xa0;good&#xa0;safety&#xa0;profile&#xa0;make it an interesting&#xa0;therapeutic&#xa0;alternative,&#xa0;especially in women of childbearing age.</p>

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Efficacy of sulfasalazine on recurrent acute anterior uveitis: a three-year follow-up

  • 期刊论文

  • 发表日期：

    2025年1月24日

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  • Ana Avello-Gorostidi,
  • Ines Hernanz,
  • Ignacio Robles-Barrena,
  • Otto Olivas-Vergara,
  • Pablo E. Borges,
  • Celia Arconada-López,
  • Fredeswinda Romero-Bueno,
  • Olga Sánchez-Pernaute,
  • Ester Carreño

摘要

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 September 2023. The grading of uveitis activity was defined as per SUN working group. The primary outcome was the reduction in the number of uveitis flare-ups over a one-year, two-year and three year-period, compared to pre-treatment year. The response criteria to SSZ were defined as normal ophthalmologic examination. Paired samples Wilcoxon test and Kaplan–Meier survival curve were calculated using R-Commander statistical software (p < 0.05).

Results

Fifty-three patients were included. Mean time of follow up was 38.51 ± 38.45 months. Nine patients developed adverse effects to SSZ (16.98%) most of them mild. Ankylosing spondylitis was the most frequent association (n = 28, 52.83%), while HLA-B27 was positive in 69.23% of the patients (n = 36). The most frequent indication for SSZ was based on ocular activity in 52.83% (n = 28). The number of flare-ups dropped from 2.25 (± 1.34) in the pre-treatment year to, 0.81 (± 0.99) at year 1 (p < 0.001), 0.61 (± 0.78) at year 2 (p < 0.001) and 0.65 (± 0.83) at year 3 (p = 0.005). The median time to flare-up of AAU after SSZ was 15.13 months (CI 95, 7.97–27.40).

Conclusion

Our data point to sulfasalazine as an effective treatment to reduce flare-ups in patients with recurrent non-infectious AAU. Its low cost and good safety profile make it an interesting therapeutic alternative, especially in women of childbearing age.