Table 1 A summary of conventional systemic immunosuppressive agents used to treat non-infectious uveitis
Medication | Mechanism | Typical dosage | Adverse effects | Price of typical one-year course of treatment for Behçet’s uveitis (£GBP)a |
|---|---|---|---|---|
T-cell inhibitors | ||||
Cyclosporine | T-cell function inhibitor | 2.5–10 mg/kg/day PO in 2 divided doses | Infections, nephrotoxicity, hypertension, hirsutism and gingival hyperplasia | 1111.43–4130.59 |
Tacrolimus | T-cell function inhibitor | 0.15–0.30 mg/kg/day PO | Infections, nephrotoxicity, hypertension, diabetes mellitus and electrolyte imbalance | 5468.43–7358.40 |
Anti-metabolites | ||||
Methotrexate | Dihydrofolate reductase inhibitor | 7.5–25 mg/week PO, SC, or IM | Infections, hepatotoxicity, oral ulcers, fatigue, alopecia, bone marrow suppression, pneumonitis, fetal loss and gastrointestinal disturbance | 2271.36–4680.00 |
Azathioprine | Purine metabolism inhibitor | 1–4 mg/kg/day PO | Infections, hepatotoxicity, fatigue, bone marrow suppression, hypersensitivity and gastrointestinal disturbance | 120.34–174.98 |
Mycophenolate mofetil | Inosine monophosphate dehydrogenase inhibitor | 500–1500 mg PO twice daily | Infections, bone marrow suppression, and gastrointestinal disturbance | 620.50–1861.50 |
Leflunomide | Dihydroorotate dehydrogenase inhibitor | 100 mg PO daily [×3 days], then 20 mg PO daily or every other day | Infections, bone marrow suppression, diarrhoea, hypertension and fetal loss | 373.27–746.54 |
Alkylating agents | ||||
Chlorambucil | Alkylates nucleic acid | 0.1–0.2 mg/kg/day PO | Infections, bone marrow suppression, increased risk of malignancy, and sterility | 2365.78–4731.57 |
Cyclophosphamide | Alkylates nucleic acid | 1–3 mg/kg/day PO | Infections, bone marrow suppression, hemorrhagic cystitis, increased risk of malignancy, sterility, and alopecia | 1014.70–2029.40 |
Other | ||||
Colchicine | Inhibits neutrophil motility | 0.5–2 mg/day PO | Infections, peripheral neuropathy, bone marrow suppression, sterility and alopecia | 265.54–1062.15 |