J Korean Ophthalmol Soc.  2007 Dec;48(12):1654-1662.

Short-term Effects and Side Effects of Tacrolimus for Behcet's Uveitis

• Moon JW
• Song SJ
• Koo BK
• Cho YM
• Yu HG

Abstract

PURPOSE: To investigate the clinical effects and side effects of Tacrolimus for ocular Behcet's disease.
METHODS
Eight patients (male: 5, age: 35+/-7.5 (25-48) years) with Behcet's uveitis, refractory posterior uveitis unresponsive to combination treatment with cyclosporine, azathioprine, and oral steroid or significant cyclosporine-related adverse effects were recruited prospectively, and cyclosporine was switched to Tacrolimus. Visual acuity, degree of anterior chamber, and vitreous haze were compared before the conversion and three months after. Oral glucose tolerance, plasma insulin, cholesterol, creatinine, and aspartate (AST)/alanine aminotransferase (ALT) were measured to monitor systemic effects.
RESULTS
Visual acuity did not change significantly after conversion to Tacrolimus. Anterior chamber (seven patients) and vitreous (four patients) inflammation were found before conversion and decreased or disappeared after conversion. Overall plasma levels of glucose, insulin, creatinine, and AST/ALT were similar before and after conversion. However, cholesterol was significantly decreased after conversion (p=0.028). One patient developed diabetes mellitus.
CONCLUSIONS
Tacrolimus may be effective for Behcet's uveitis unresponsive to or intolerable of traditional treatments. In addition, periodic monitoring for side effects, such as hyperglycemia and diabetes mellitus, may be necessary.

Keyword

Behcet's uveitis; Cyclosporine; Tacrolimus

MeSH Terms

Anterior Chamber
Aspartic Acid
Azathioprine
Cholesterol
Creatinine
Cyclosporine
Diabetes Mellitus
Glucose
Glucose Tolerance Test
Humans
Hyperglycemia
Inflammation
Insulin
Plasma
Prospective Studies
Tacrolimus*
Uveitis*
Uveitis, Posterior
Visual Acuity
Aspartic Acid
Azathioprine
Cholesterol
Creatinine
Cyclosporine
Glucose
Insulin
Tacrolimus

Figure

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  Figure 1. Comparison of plasma glucose concentrations (oral glucose tolerance test) before and 3 months after conversion from cyclosporine to Tacrolimus. No significant differences are found at all points.

• 

  Figure 2. Comparison of plasma insulin concentrations during oral glucose tolerance test before and 3 months after conversion from cyclosporine to Tacrolimus. No significant differences are found at all points.

Reference

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