Inflammatory Relapses after Immunosuppressive Drug Discontinuation in Uveitis Patients: A Survival Analysis

Ocul Immunol Inflamm. 2021 Feb 17;29(2):376-387. doi: 10.1080/09273948.2019.1681469. Epub 2019 Nov 11.

Abstract

Purpose: To estimate the incidence rate (IR) and identify risk factors associated to inflammatory relapse after immunosuppressive drug (ISD) discontinuation in noninfectious uveitis patients.Methods: Multicenter longitudinal retrospective study, including patients from four uveitis clinics followed-up until December 2018. Hazard ratios for different variables were estimated using multivariable Cox models.Results: 32 patients (34 episodes of ISD discontinuation) were analyzed (median and maximum follow-up time: 2.4 and 19.2 years, respectively). Fourteen patients presented at least one relapse: anterior (8 patients), intermediate (5) and posterior (8). IR (95% confidence interval) of the first relapse was 14.3 (8.6-23.8) episodes per 100 patient-years (median survival time: 4.8 years). Early use of ISDs, panuveitis, and higher oral corticosteroid dosage at discontinuation were associated with higher hazards of relapse in multivariable analysis.Conclusions: Relapse is a frequent and early event after ISD discontinuation. Identifying relapse risk factors could support the physician's decision regarding ISD discontinuation.

Keywords: immunosuppressive drug; inflammatory relapse; oral corticosteroids; uveitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Inflammation / diagnosis
  • Inflammation / epidemiology*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Survival Analysis
  • Treatment Outcome
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Visual Acuity
  • Withholding Treatment*
  • Young Adult

Substances

  • Immunosuppressive Agents