Comparison of the clinical efficacy of two different immunosuppressive regimens in patients with chronic Vogt-Koyanagi-Harada disease

Purpose: To prospectively compare 2 immunosupressive regimens in patients with active Vogt-Koyanagi-Harada disease in spite of systemic glucocorticoid treatment. Methods: Forty-four patients were diagnosed between 1998 and 2005. Twenty-one developed chronic intraocular inflammation in spite of glucocorticoid treatment and were randomized to receive either prednisone and azathioprine (AZA) (n = 12) or prednisone and cyclosporine (CyA) (n = 9). Results: In the AZA group Tyndall score decreased from 1.21±1.10 to 0.29±0.62 (p<.01), and visual acuity (LogMAR) improved from 0.32±0.35 to 0.09±0.16 (p<.001). In the CyA group Tyndall score decreased from 1.67±1.08 to 0.16±0.51 (p<.001), and visual acuity improved from 0.41±0.40 to 0.25±0.42 (p<.001). Patients in the AZA group needed a significantly higher average prednisone dose and total cumulative dose than those in the CyA group, p<.01 for each comparison. Conclusions: Both regimens showed a good clinical efficacy, but CyA seems to be a bet