Uvéites et biothérapies

Feurer, Elodie; Bielefeld, P.; Saadoun, David; Sève, P.

doi:10.1016/j.revmed.2014.07.008

Cited by 10 publications

(3 citation statements)

References 88 publications

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“…In contrast, other studies found a preeminence of immunosuppressive agents (Mycophenolate mofetil, Ciclosporine A, Methotrexate, and Azathioprine) over corticosteroids alone, while others were more reserved [26,30]. Finally, biological therapies are used in non-infectious uveitis including VKH disease [31] but the treatment length in VKH disease is still debated.…”

Section: Discussionmentioning

confidence: 99%

Vogt-Koyanagi-Harada disease: a retrospective and multicentric study of 41 patients

Diallo

Revuz²,

Clavel-Refregiers

et al. 2020

BMC Ophthalmol

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Background East and South East Asian subjects as well as Amerindians and Hispanic subjects are predominantly affected by Vogt-Koyanagi-Harada disease. In Europe, only few studies have described the clinical features and treatment of this disease, especially in France. Methods This retrospective case series was based on data collected from patients with a VKH disease diagnosed from January 2000 to March 2017, provided by three French Tertiary Centers. Results Forty-one patients (16 men and 25 women) were diagnosed: average age at diagnosis was 38.7 years. Patients were mainly from Maghreb (58%), but ethnic origins were multiple. Pleiocytosis was observed in 19 cases (63%) and 17 out of 41 patients showed audio vestibular signs (41%), and 11 showed skin signs (27%). Thirty-four were treated with corticosteroids (83%), 11 with an immunosuppressant treatment (27%) and 5 with biological therapy drugs (13%). Relapse was observed in 41% patients, even though final average visual acuity had improved. We did not find any significant clinical difference in the population from Maghreb compared to other populations, but for age and sex trends, since there was a majority of younger women. Conclusion We report here the second largest French cohort reported to date to our knowledge. The multiethnicity in our study suggests that VKH disease should be evoked whatever patients’ ethnicity.

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Section: Discussionmentioning

confidence: 99%

Vogt-Koyanagi-Harada disease: a retrospective and multicentric study of 41 patients

Diallo

Revuz²,

Clavel-Refregiers

et al. 2020

BMC Ophthalmol

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“…Le certolizumab pégol est administré à la dose de 200 mg tous les 15 jours par voie sous-cutanée avec une première injection de 200 mg×2 (41). * Immunoglobulines intraveineuses (IgIV) Les IgIV sont des préparations thérapeutiques d'IgG humaines, à partir d'un pool de plasma de plus de 1000 individus sains (43). Les IgIV sont administrées par la voie intraveineuse à la dose de 0,8 à 2 g/kg répartis sur un à cinq jours.…”

Section: * Tocilizumabunclassified

“…Les IgIV sont administrées par la voie intraveineuse à la dose de 0,8 à 2 g/kg répartis sur un à cinq jours. En cas d'efficacité et de bonne tolérance, les cures d'IgIV sont répétées quatre à six fois, toutes les quatre semaines (43). Rituximab (RTX) Le RTX est un anticorps monoclonal dirigé contre l'antigène CD20 des lymphocytes B matures.…”

Section: * Tocilizumabunclassified

Traitement de la maladie de Vogt-Koyanagi-Harada : Une revue narrative de la littérature

Kadir¹,

Oumarou²,

Moussa³

2022

Ann. Afr. Med

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Non-traumatic, exudative, bilateral panuveitis associated with extraocular manifestations, Vogt-Koyanagi-Harada disease (VKH) is an autoimmune disease mediated by Th1 lymphocytes reacting against melanocytes. It is a rare disease with female predominance. VKH disease is a diagnostic and therapeutic emergency. Treatment is based mainly on early and aggressive corticosteroid therapy to shorten the duration of the disease, prevent progression to chronicity, and reduce the incidence of extraocular manifestations. It is a corticosteroid-responsive disease, but unfortunately, relapses in the form of anterior uveitis are not rare, mainly at the time or at the end of tapering of corticosteroids. In these situations, or in case of intolerance to prolonged corticosteroid therapy, the use of conventional immunosuppressive agents or immunomodulatory drugs able to suppress the lymphocyte response is recommended. Intravenous immunoglobulins may also be used in patients with relapse or attack of the disease. In the present study, we performed a narrative literature review to summarize the different therapeutic aspects of VKH in the form of treatment algorithm. Panuvéite bilatérale non traumatique, exsudative, associée à des manifestations extraoculaires, la maladie de Vogt-Koyanagi-Harada (VKH) est une maladie auto-immune médiée par les lymphocytes Th1 réagissant contre les mélanocytes. C’est une maladie rare à prédominance féminine. La maladie de VKH est une urgence diagnostique et thérapeutique. Le traitement repose essentiellement sur une corticothérapie précoce et agressive avec possibilité de dégression progressive lente sur plusieurs mois, afin deraccourcir la durée de la maladie, d’empêcher la progression vers la chronicité, et de réduire l’incidence des manifestations extraoculaires. C’est une maladie corticosensible, mais malheureusement des rechutes sous forme d’uvéite antérieure ne sont pas rares, principalement au moment ou en fin de dégression de la corticothérapie. Dans ces situations ou en cas d’intolérance à la corticothérapie prolongée, le recours aux immunosuppresseurs conventionnels ou médicaments immunomodulateurs capables de supprimer la réponse lymphocytaire est de règle. Les immunoglobulines intraveineuses peuvent également être proposées chez les patients présentant une rechute ou une poussée de la maladie. Dans la présente étude, nous réalisons une revue narrative de la littérature en décrivant les différents aspects thérapeutiques de la maladie de VKH afin de les résumer sous forme d’un algorithme thérapeutique.

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