Evidence map›Paper›PMID 38466527›Full record

ArticleJournal of ophthalmic inflammation and infection2024

Intravenous cyclophosphamide therapy for patients with severe ocular inflammatory diseases who failed other immunomodulatory therapies.

Irmak Karaca, Elaine M Tran, SungWho Park, Albert Bromeo, Hassan Khojasteh, Anh Ngọc Tram Tran, Negin Yavari, Amir Akhavanrezayat, Cigdem Yasar, Gunay Uludag Kirimli and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of ophthalmic inflammation and infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Update on Therapy for Non-Infectious Scleritis.Clinical ophthalmology (Auckland, N.Z.) · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 1 country.

Irmak KaracaSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Elaine M TranSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
SungWho ParkSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Albert BromeoSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Hassan KhojastehSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Anh Ngọc Tram TranSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Negin YavariSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Amir AkhavanrezayatSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Cigdem YasarSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Gunay Uludag KirimliSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Ngoc Tuong Trong ThanSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Muhammad HassanSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Christopher OrSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Hashem GhorabaSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Diana V DoSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Quan Dong NguyenSpencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA. ndquan@stanford.edu.
Smith-Kettlewell Eye Research Institute · USStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOcular inflammatory diseases, including scleritis and uveitis, have been widely treated with immunomodulatory therapies (IMTs) as a steroid-sparing approach. Such strategy includes conventional therapies (antimetabolites, alkylating agents, and calcineurin inhibitors) as well as biologic agents like adalimumab, infliximab, rituximab, and tocilizumab. Cyclophosphamide (CP) is an alkylating agent and mainly inhibits the functioning of both T and B cells. Though known to have potential adverse events, including bone marrow suppression, hemorrhagic cystitis, and sterility, CP has been shown to be efficacious, especially in recalcitrant cases and when used intravenous (IV) for a limited period. MAIN

findingsWe conducted a retrospective case-series to assess the safety and efficacy of CP therapy for patients with severe ocular inflammatory diseases who failed other IMTs. Medical records of 1295 patients who presented to the Uveitis Clinic at the Byers Eye Institute at Stanford between 2017 and 2022 were reviewed. Seven patients (10 eyes) who received CP therapy for ocular inflammatory diseases with at least one year of follow-up were included. The mean age of the patients (4 males, 3 females) was 61.6 ± 14.9 (43.0-89.0) years. Clinical diagnoses included necrotizing scleritis (5 eyes), peripheral ulcerative keratitis (2 eyes), orbital pseudotumor (1 eye), HLA-B27 associated panuveitis and retinal vasculitis (2 eyes). Ocular disease was idiopathic in 3 patients, and was associated with rheumatoid arthritis, IgG-4 sclerosing disease, dermatomyositis, and ankylosing spondylitis in 1 patient each. All the patients had history of previous IMT use including methotrexate (5), mycophenolate mofetil (3), azathioprine (1), tacrolimus (1), adalimumab (2), infliximab (4), and rituximab (1). The mean follow-up time was 34.4 ± 11.0 (13-45) months, and mean duration of CP therapy was 11.9 ± 8.8 (5-28) months. Remission was achieved in 5 patients (71.4%). Four patients (57.1%) experienced transient leukopenia (white blood cell count < 4000/mL). SHORT

conclusionCP therapy can be considered a potentially effective and relatively safe therapeutic option for patients with severe ocular inflammatory diseases who failed other IMTs including biologics (TNFa and CD20 inhibitors).

Indexed as

CyclophosphamideImmunomodulatory therapyRefractoryScleritisSevereUveitis

Identifiers

PMID38466527
PMCPMC10928035
OpenAlexW4392659331

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.