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쇼그렌증후군 건성안 환자에서 0.1% 싸이클로스포린 A 점안액의 순응도 조사

Assessment of the Compliance with 0.1% Cyclosporine A in Dry-Eye Patients with Sjögren's Syndrome

윤희수|윤현정|윤경철|진형남|박도희
대한안과학회 (The Korean Ophthalmological Society)|2021.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제62권 제7호|pp. 895-903

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키워드

ComplianceCyclosporine ADry eyeSjögren's syndromeCationic emulsion
주제분류안과학

초록

목적: 쇼그렌증후군 건성안 환자에서 0.1% 싸이클로스포린 A 점안액의 순응도와 이에 영향을 미치는 인자를 알아보고자 하였다. 대상과 방법: 6개월 이상 0.1% 싸이클로스포린 A 점안액을 사용한 쇼그렌증후군 건성안 환자 67명을 대상으로 조사를 시행하였다. 성별, 나이, 사용 안약의 수, 약물 사용 시 부작용, 스테로이드 점안액의 사용 유무, 외래진료 간격을 조사하였으며, 안구표면질환지수, 눈물막파괴시간, 쉬르머검사 수치, 각막형광염색점수를 평가하였다. 대상 환자를 순응도 50% 기준으로 나누어, 순응도가 좋은 군과 좋지 않은 군에 따른 관련 인자를 비교 분석하였다. 결과: 67명의 환자 중 순응도가 좋은 군은 36명(53.7%), 순응도가 좋지 않은 군은 31명(46.3%)이었다. 경과 관찰 6개월째, 순응도가 좋은 군에서 순응도가 좋지 않은 군에 비해 긴 눈물막파괴시간(p=0.03) 및 낮은 각막형광염색점수(p=0.04)를 보였다. 부작용 발생 비율은 39명(58.2%)이었으며, 가장 흔한 부작용의 종류는 찌르는 듯한 통증(71.8%)이었다. 다변량 로지스틱 회귀분석에서 건성안 증상이 심한 경우(p=0.03), 스테로이드 점안액을 사용하지 않는 경우(p=0.02), 외래진료 간격이 긴 경우(p=0.02)가 순응도를 떨어뜨리는 인자로 나타났다. 결론: 쇼그렌증후군 건성안 환자의 0.1% 싸이클로스포린 A 점안액의 순응도를 떨어뜨리는 인자로 건성안 증상이 심한 경우, 외래진료 간격이 긴 경우, 스테로이드 점안액을 사용하지 않는 경우가 있으며 상기 인자들을 고려하는 것이 순응도를 높이는 데에 도움이 될 수 있겠다.

Abstract

Purpose: To evaluate the compliance with 0.1% cyclosporine A in dry eye patients with Sjögren's syndrome and identify factors affecting the compliance. Methods: This study included 67 dry eye patients with Sjögren's syndrome who had used 0.1% cyclosporine A for over 6 months. Clinical parameters including sex, age, the number of eye drops used, side effects, the use of steroid eye drops, and the visit interval were investigated. Additionally, the ocular surface disease index, tear break-up time (TBUT), Schirmer test score, and corneal fluorescein staining (CFS) score were assessed. Patients were classified into compliant and non-compliant groups, using a criterion of 50% compliance; relevant factors were evaluated accordingly. Results: Of the 67 patients, 36 (53.7%) were classified into the compliant group and 31 (46.3%) into the non-compliant group. Compared to the non-compliant group, the compliant group showed a longer TBUT (p = 0.03) and a lower CFS score (p = 0.04) at 6 months of follow-up. Altogether, 39 subjects (58.2%) experienced side effects, of which the most common was stinging pain (71.8%). In the multivariate analysis, severe dry-eye symptoms (p = 0.03), non-use of the steroid eye drops (p = 0.02), and longintervals between exam vitists (p = 0.02) were identified as factors reducing compliance. Conclusions: Factors related to a decrease in the compliance with 0.1% cyclosporine A in dry-eye patients with Sjögren's syndrome, included severe dry eye symptoms, long visit intervals, and non-use of steroid eye drops. Taking these factors into consideration may help increase patient compliance.

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