In patients with intractable, sight-threatening, non-infectious uveitis, the drug chlorambucil, a chemotherapeutic agent known to cause cancer in some patients when dispensed long-term, was found effective in alleviating inflammation when administered in high doses for a short time.
The design of the study was a chart review of 53 patients who had been treated at the medical center with high-dose, short-term chlorambucil between 1973 and 1999. With an average follow-up period of four years, 77 percent of the treated patients experienced no recurrence of uveitis, and all patients remained cancer-free. The results appear in the February issue of Ophthalmology, the clinical journal of the American Academy of Ophthalmology.
"The exciting thing about chlorambucil is that it seems to reduce the inflammation in many patients for the long term," said lead author Dr. Debra Goldstein, assistant professor of ophthalmology at the UIC College of Medicine and associate director of the medical center's uveitis service. "Many patients treated with other drugs, such as prednisone and cyclosporine, relapse as soon as the treatment is stopped."
However, Goldstein cautioned, because of the carcinogenic nature of chlorambucil, patients need to be closely monitored.
"Only physicians specializing in or very familiar with the treatment of uveitis and the use of immunosuppressive agents should utilize this treatment," she said. "The treating ophthalmologist may want to work in concert with another physician comfortable with the use of agents such as chlorambucil."
Uveitis is a condition that can be enigmatic and attributable to any number of causes, both infectious and non-infectious. Chlorambucil is used only in non-infectious cases, whic
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Contact: Nan Hoffman
nanhoff@uic.edu
312-355-2954
University of Illinois at Chicago
5-Feb-2002