American Journal of Ophthalmology
Volume 148, Issue 4 , Pages 500-509.e2 , October 2009

Azathioprine for Ocular Inflammatory Diseases

  • Sirichai Pasadhika

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • ,
  • John H. Kempen

      Affiliations

    • Ocular Inflammation Service, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
    • Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
    • Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
    • Corresponding Author InformationInquiries to John H. Kempen, Department of Ophthalmology, University of Pennsylvania, 3535 Market Street, Suite 700, Philadelphia, PA 19104
    • ,
  • Craig W. Newcomb

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
    • ,
  • Teresa L. Liesegang

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • ,
  • Siddharth S. Pujari

      Affiliations

    • Massachusetts Eye Research and Surgery Institution, Cambridge, Massachusetts
    • ,
  • James T. Rosenbaum

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • Department of Internal Medicine, Oregon Health & Science University, Portland, Oregon
    • ,
  • Jennifer E. Thorne

      Affiliations

    • Department of Ophthalmology, The Johns Hopkins University, Baltimore, Maryland
    • Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland
    • ,
  • C. Stephen Foster

      Affiliations

    • Massachusetts Eye Research and Surgery Institution, Cambridge, Massachusetts
    • Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
    • ,
  • Douglas A. Jabs

      Affiliations

    • Department of Ophthalmology, The Johns Hopkins University, Baltimore, Maryland
    • Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland
    • Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York
    • Department of Medicine, Mount Sinai School of Medicine, New York, New York
    • ,
  • Grace A. Levy-Clarke

      Affiliations

    • Laboratory of Immunology, National Eye Institute, Bethesda, Maryland
    • St Luke's Cataract and Laser Institute, Tarpon Springs, Florida
    • ,
  • Robert B. Nussenblatt

      Affiliations

    • Laboratory of Immunology, National Eye Institute, Bethesda, Maryland
    • ,
  • Eric B. Suhler

      Affiliations

    • Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
    • Portland Veteran's Affairs Medical Center, Portland, Oregon

,Accepted 4 May 2009.

References 

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  5. Gisbert JP, Nino P, Cara C, Rodrigo L. Comparative effectiveness of azathioprine in Crohn's disease and ulcerative colitis: prospective, long-term, follow-up study of 394 patients. Aliment Pharmacol Ther. 2008;28:228–238
  6. Lee JC, Gladman DD, Schentag CT, Cook RJ. The long-term use of azathioprine in patients with psoriatic arthritis. J Clin Rheumatol. 2001;7:160–165
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  10. Greenwood AJ, Stanford MR, Graham EM. The role of azathioprine in the management of retinal vasculitis. Eye. 1998;12:783–788
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  13. Moore CE. Sympathetic ophthalmitis treated with azathioprine. Br J Ophthalmol. 1968;52:688–690
  14. Hooper PL, Kaplan HJ. Triple agent immunosuppression in serpiginous choroiditis. Ophthalmology. 1991;98:944–951
  15. Kempen JH, Daniel E, Gangaputra S, et al. Methods for identifying long-term adverse effects of treatment in patients with eye diseases: the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study. Ophthalmic Epidemiol. 2008;15:47–55
  16. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data (Results of the First International Workshop). Am J Ophthalmol. 2005;140:509–516
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  18. Lin DY, Wei LJ. The robust inference for the Cox proportional hazards model. J Am Stat Assoc. 1989;84:1074–1078
  19. Galor A, Jabs DA, Leder HA, et al. Comparison of antimetabolite drugs as corticosteroid-sparing therapy for noninfectious ocular inflammation. Ophthalmology. 2008;115:1826–1832
  20. Andrasch RH, Pirofsky B, Burns RP. Immunosuppressive therapy for severe chronic uveitis. Arch Ophthalmol. 1978;96:247–251
  21. Gangaputra S, Newcomb CW, Liesegang T, et al. Methotrexate for ocular inflammatory diseases. Ophthalmology. 2009;Forthcoming
  22. Saway PA, Heck LW, Bonner JR, Kirklin JK. Azathioprine hypersensitivity (Case report and review of the literature). Am J Med. 1988;84:960–964
  23. Kempen JH, Gangaputra S, Daniel E, et al. Long-term risk of malignancy among patients treated with immunosuppressive agents for ocular inflammation: a critical assessment of the evidence. Am J Ophthalmol. 2008;146:802–812
  24. Kempen JH, Daniel E, Dunn JP, et al. Risk of overall and cancer mortality among patients with ocular inflammation treated with immunosuppressive therapy: retrospective cohort study. Br Med J. 2009;Forthcoming
  25. Goldstein LH, Dolinsky G, Greenberg R, et al. Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol. 2007;79:696–701
  26. Alstead EM, Ritchie JK, Lennard-Jones JE, Farthing MJ, Clark ML. Safety of azathioprine in pregnancy in inflammatory bowel disease. Gastroenterology. 1990;99:443–446

 Supplemental Material available at AJO.com.

PII: S0002-9394(09)00345-6

doi: 10.1016/j.ajo.2009.05.008

American Journal of Ophthalmology
Volume 148, Issue 4 , Pages 500-509.e2 , October 2009

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