Hydroxychloroquine Therapy in Sarcoidosis-Associated Uveitis

Ocul Immunol Inflamm. 2024 Feb;32(2):154-160. doi: 10.1080/09273948.2023.2165952. Epub 2023 Feb 7.

Abstract

Background/purpose: To assess the efficacy and tolerance of hydroxychloroquine in sarcoidosis-associated uveitis.

Methods: Retrospective study on all patients with sarcoidosis-associated uveitis who were treated with hydroxychloroquine between 2003 and 2019 in a French university hospital.

Results: Twenty-seven patients with sarcoidosis-associated uveitis received hydroxychloroquine. The mean duration of treatment was 20.0 ± 10.9 months. At the end of the follow-up, hydroxychloroquine success was achieved in 15 (55.6%) patients. Four of them were also on oral corticosteroids, with a prednisone dose ≤5 mg/day. Under treatment, the median prednisone dose decreased from 20.0 (interquartile range (IQR), 7-25) to 5.0 (IQR, 3-6.5) mg/day (p = .02). The incidence rate of flare decreased from 204.6 to 63.8 per 100 person-years (p = .02). Hydroxychloroquine was discontinued in 12 (44.4%) patients during follow-up, including 8 (29.6%) for ineffectiveness, and three who experienced side effects.

Conclusion: Hydroxychloroquine appears as an interesting option in sarcoidosis-associated uveitis.Abbreviations: AZA: Azathioprine; BAL: Bronchoalveolar Lavage; BCVA: Best-Corrected Visual Acuity; ENT: Ears, Nose and Throat; HCQ: Hydroxychloroquine; IOP: Intra-Ocular Pressure; IQR: interquartile range; MHC: Major Histocompatibility Complex; MMF: Mycophenolate Mofetil; MTX: Methotrexate; PMSI: Programme de Médicalisation du Système d'Information; SAU: Sarcoidosis-Associated Uveitis; SD: Standard Deviation; SUN: Standard Uveitis Nomenclature.

Keywords: Hydroxychloroquine; sarcoidosis; uveitis.

MeSH terms

  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate / therapeutic use
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / therapeutic use
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Sarcoidosis* / complications
  • Sarcoidosis* / diagnosis
  • Sarcoidosis* / drug therapy
  • Treatment Outcome
  • Uveitis* / complications
  • Uveitis* / diagnosis
  • Uveitis* / drug therapy

Substances

  • Immunosuppressive Agents
  • Prednisone
  • Hydroxychloroquine
  • Methotrexate
  • Mycophenolic Acid