Abstract：
UNASSIGNED: Patients with sight-threatening inflammatory eye disease (IED) are maintained on systemic immunosuppression whilst in long-term clinical remission. There are no clear guidelines on the duration of remission before implementing treatment withdrawal. We present a real-world analysis on the use of immunosuppression in IED in long-term remission and consider strategies for withdrawal.
UNASSIGNED: Adult IED patients on systemic immunosuppression were categorised into four disease groups: Corneal Transplant Survival Strategies (CTSS), Ocular Surface Disease (OSD), Non-infectious Uveitis (NIU) and Scleritis. Patients with Behçet\'s disease were excluded. Data on systemic immunosuppressants and biologics used; duration of treatment; reasons for drug discontinuation; disease activity/remission status; duration of clinical remission with an emphasis on patients who had been in remission for a minimum of 24 months were captured.
UNASSIGNED: Out of a total of 303 IED patients, 128 were on systemic immunosuppression with a clinical remission of their ocular disease for ≥24 months. The median duration of remission was 4-5 years with the longest duration of remission 22 years, and some patients on immunosuppression for up to 23 years. Sixty patients stopped at least one immunosuppressive agent without prior discussion with a health-care practitioner.
UNASSIGNED: Progressive conditions, such as cicatrising conjunctivitis may require lifelong immunosuppression, but patients with NIU and Scleritis and those on CTSS, immunosuppression withdrawal should be considered if they remain in remission for 2 years. Any patient stopping a medication should be contacted immediately for counselling. These data will better inform patients, encourage adherence and aide formal guideline development.
UNASSIGNED: Adult IED patients on systemic immunosuppression were categorised into four disease groups: Corneal Transplant Survival Strategies (CTSS), Ocular Surface Disease (OSD), Non-infectious Uveitis (NIU) and Scleritis. Patients with Behçet\'s disease were excluded. Data on systemic immunosuppressants and biologics used; duration of treatment; reasons for drug discontinuation; disease activity/remission status; duration of clinical remission with an emphasis on patients who had been in remission for a minimum of 24 months were captured.
UNASSIGNED: Out of a total of 303 IED patients, 128 were on systemic immunosuppression with a clinical remission of their ocular disease for ≥24 months. The median duration of remission was 4-5 years with the longest duration of remission 22 years, and some patients on immunosuppression for up to 23 years. Sixty patients stopped at least one immunosuppressive agent without prior discussion with a health-care practitioner.
UNASSIGNED: Progressive conditions, such as cicatrising conjunctivitis may require lifelong immunosuppression, but patients with NIU and Scleritis and those on CTSS, immunosuppression withdrawal should be considered if they remain in remission for 2 years. Any patient stopping a medication should be contacted immediately for counselling. These data will better inform patients, encourage adherence and aide formal guideline development.
摘要：
患有威胁视力的炎性眼病(IED)的患者在长期临床缓解的同时维持全身性免疫抑制。在实施停药治疗之前，没有关于缓解持续时间的明确指南。我们对长期缓解IED中免疫抑制的使用进行了实际分析，并考虑了戒断策略。
■接受全身性免疫抑制的成年IED患者分为四个疾病组：角膜移植生存策略（CTSS），眼表疾病（OSD），非感染性葡萄膜炎（NIU）和巩膜炎。患有Behçet病的患者被排除在外。有关使用的全身免疫抑制剂和生物制剂的数据；治疗持续时间；停药的原因；疾病活动/缓解状态；临床缓解持续时间，重点是缓解至少24个月的患者。
■在总共303名IED患者中，128例接受全身免疫抑制治疗，眼部疾病临床缓解时间≥24个月。中位缓解时间为4-5年，最长缓解时间为22年，和一些患者的免疫抑制长达23年。60名患者在没有事先与保健医生讨论的情况下停用了至少一种免疫抑制剂。
■渐进条件，如结膜炎可能需要终生免疫抑制，但是患有NIU和巩膜炎以及CTSS的患者，如果患者持续缓解2年,则应考虑停用免疫抑制.任何停止用药的患者应立即联系咨询。这些数据将更好地告知患者，鼓励遵守并协助正式的指导方针制定。
■接受全身性免疫抑制的成年IED患者分为四个疾病组：角膜移植生存策略（CTSS），眼表疾病（OSD），非感染性葡萄膜炎（NIU）和巩膜炎。患有Behçet病的患者被排除在外。有关使用的全身免疫抑制剂和生物制剂的数据；治疗持续时间；停药的原因；疾病活动/缓解状态；临床缓解持续时间，重点是缓解至少24个月的患者。
■在总共303名IED患者中，128例接受全身免疫抑制治疗，眼部疾病临床缓解时间≥24个月。中位缓解时间为4-5年，最长缓解时间为22年，和一些患者的免疫抑制长达23年。60名患者在没有事先与保健医生讨论的情况下停用了至少一种免疫抑制剂。
■渐进条件，如结膜炎可能需要终生免疫抑制，但是患有NIU和巩膜炎以及CTSS的患者，如果患者持续缓解2年,则应考虑停用免疫抑制.任何停止用药的患者应立即联系咨询。这些数据将更好地告知患者，鼓励遵守并协助正式的指导方针制定。
