Immunomodulatory Therapy for Vogt-Koyanagi-Harada Patients as First-Line Therapy

  title={Immunomodulatory Therapy for Vogt-Koyanagi-Harada Patients as First-Line Therapy},
  author={Ian Paredes and M D Fazal Ahmed and Christopher S Foster},
  journal={Ocular Immunology and Inflammation},
  pages={87 - 90}
Purpose: To report on the use of immunomodulatory therapy (IMT) in a group of patients with Vogt-Koyanagi-Harada disease (VKH) and to compare the outcomes with those of another group of patients with VKH who were treated for prolonged periods with corticosteroids. Methods: Treatment regimens and their respective outcomes (visual acuity) were compared for the following groups: prolonged steroid with or without delayed addition of IMT (Group 1) and relatively prompt IMT with or without steroid… 
Early Versus Late Immunomodulatory Therapy in Vogt-koyanagi-harada Disease
Early IMT in VKH may allow for shorter duration of corticosteroids with similar visual outcomes, ocular complications, and disease recurrences, according to a retrospective review of patients seen at LAC+USC.
Efficacy of Rituximab Treatment in Vogt-Koyanagi-Harada Disease Poorly Controlled by Traditional Immunosuppressive Treatment.
Retrospective case series of recurrent VKH uveitis treated with intravenous RTX showed that RTX was effective in VHK disease poorly controlled by traditional immunosuppressive treatment.
Comparison of the Clinical Efficacy of Two Different Immunosuppressive Regimens in Patients with Chronic Vogt-Koyanagi-Harada Disease
Both regimens showed a good clinical efficacy, but CyA seems to be a better glucocorticoid-sparing agent than AZA, which needed a significantly higher average prednisone dose and total cumulative dose than those in the AZA group.
Vogt-Koyanagi-Harada Syndrome in Children: Report of a Case and Review of the Literature
A 9-year-old girl with progressive visual loss due to VKH syndrome in spite of treatment is reported on, and triple combination of corticosteroids, cyclosporine, and methotrexate suppressed the relapses of intraocular inflammation.
Infliximab Therapy for 2 Patients with Vogt-Koyanagi-Harada Syndrome
Infliximab may be effective treatment for VKH, and spares patients the side effects of corticosteroids and conventional immunosuppressive drugs.
The Use of Low-Dose Azathioprine in Patients with Vogt-Koyanagi-Harada Disease
  • S. Kim, H. Yu
  • Medicine
    Ocular immunology and inflammation
  • 2007
Low-dose azathioprine therapy may be effective as corticosteroid sparing agent in Vogt-Koyanagi-Harada (VKH) disease patients.
Rituximab in refractory Vogt–Koyanagi–Harada disease
This is the first report of VKH disease treated with rituximab, and additional studies are warranted to confirm the efficacy of this new approach for inflammatory control in refractory cases ofVKH disease.
Long term treatment with infliximab in pediatric Vogt-Koyanagi-Harada disease
Comparison of combination therapy of prednisolone and cyclosporine with corticosteroid pulse therapy in Vogt–Koyanagi–Harada disease
Combination therapy was noninferior to corticosteroid therapy with respect to recurrence/worsening risk, sunset glow fundus grade, and cataract rate were lower in the combination group than in the cortiosteroid group.
Vogt-Koyanagi-Harada disease in Spain
VKH in Spain mostly affects women and presents as incomplete acute stage disease and visual prognosis is good, with cataract and glaucoma are the two most frequent complications.


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Intensive and prolonged systemic treatment with corticosteroids is recommended for the patients with first attack ofVKH syndrome, where as regular treatment with chlorambucil is useful for control of chronic and recurrent uveitis seen in VKH syndrome.
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These results indicate that both regimens of oral prednisone are feasible for treating patients with VKH, and regimen 1 is far better than regimen 2 with respect to visual prognosis, frequency of recurrence of uveitis as well as incidence of ocular complications.
Studies on corticosteroid therapy in Vogt-Koyanagi-Harada disease.
  • Y. Sasamoto, S. Ohno, H. Matsuda
  • Medicine
    Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde
  • 1990
The findings are in support of systemic corticosteroid therapy (pulse and high-dose) in the treatment of Vogt-Koyanagi-Harada disease.
Systemic corticosteroid treatment in Vogt-Koyanagi-Harada disease
It is suggested that the dosage of corticosteroid should be adjusted according to the severity of uveomeningitis, while a drip infusion of the massive dosage with gradual tapering off is possibly requisite in the Vogt-Koyanagi type.
Cyclosporin therapy in Vogt Koyanagi Harada disease.
Three cases of VKHD who either failed to respond to high-dose corticosteroid (oral and intravenous) therapy alone or developed significant side effects are reported, one of whom subsequently showed a beneficial response and another a transient beneficial response to cyclosporin therapy.
Vogt-Koyanagi-Harada syndrome. Clinical course, therapy, and long-term visual outcome.
The early, aggressive use of systemic corticosteroids in patients with Vogt-Koyanagi-Harada syndrome and a gradual tapering of drug dosage for 6 months after presentation are recommended.
FK506 treatment of noninfectious uveitis.
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This long term study demonstrates the potential efficacy of CsA in the treatment of severe intra-ocular inflammatory disorders, however, it is firmly believed that only in the context of a randomized clinical trial that a definitive evaluation as to the true effectiveness ofCsA will be reached.
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A clinic-based cross-sectional survey and retrospective review of pediatric patients with VHK seen in the uveitis clinic at the Aravind Eye Hospital, Madurai, India, between January 1993 and December 1995 found that VKH syndrome may affect children.