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Master Thesis

Uvéites non infectieuses : étude des facteurs prédictifs d’échec du traitement immunosuppresseur conventionnel

Abstract : Purpose: methotrexate and mycophenolate mofetil are the corticosteroid-sparing agents most currently prescribed in patients with non-infectious non-anterior uveitis. Recently other treatments such as anti-TNFα have been approved. The aim of this study is to identify the predictors of methotrexate and mycophenolate mofetil treatment failure within the year after their introduction. Methods: this is a retrospective monocentric study including patients with non-anterior non- infectious uveitis treated with methotrexate or mycophenolate mofetil between 2010 and 2018. Demographic, therapeutic, immunological and ophthalmological data were collected at the introduction of immunosuppressive treatment. Results: 95 eyes were included, 60 eyes (63%) responded to treatment while 35 eyes (37%) were considered as treatment failure. In multivariate analyses, the independent risk factors of failure one year after introducing immunosuppressive treatment were: posterior uveitis (OR=6.49 ; 95% CI, 1.90-22.20) and macular thickness over 350 microns (OR=4.57 ; 95% CI, 1.53-13.65). Conclusions: patients with posterior uveitis and macular thickness over 350 microns are most at risk of standard immunosuppressive treatment failure with methotrexate or mycophenolate mofetil. This should lead to discuss the prescription of anti-TNFα when a non-steroid systemic immunomodulatory treatment is required for these patients.
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https://dumas.ccsd.cnrs.fr/dumas-02433726
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Camille Prot-Leurent. Uvéites non infectieuses : étude des facteurs prédictifs d’échec du traitement immunosuppresseur conventionnel. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02433726⟩

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