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Long-term outcomes of noninfectious uveitis treated with systemic immunomodulatory therapy: a retrospective case series.
Felfeli, Tina; Balas, Michael; Tai, Felicia; Eshtiaghi, Arshia; Rhee, Jess; Kaplan, Alexander J; Christakis, Panos G; Mandelcorn, Efrem D; Bakshi, Nupura K; Rubin, Laurence A; Derzko-Dzulynsky, Larissa A.
Afiliación
  • Felfeli T; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON; Toronto Health Economics and Technology Assessment (THETA) Collaborative, Univer
  • Balas M; Temerty Faculty of Medicine, University of Toronto, Toronto, ON.
  • Tai F; Division of Ophthalmology, McMaster University, Hamilton, ON.
  • Eshtiaghi A; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON.
  • Rhee J; Faculty of Medicine, Schulich School of Medicine and Dentistry, London, ON.
  • Kaplan AJ; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON; Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON.
  • Christakis PG; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON.
  • Mandelcorn ED; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON; Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON.
  • Bakshi NK; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON; Department of Ophthalmology, Mount Sinai Hospi
  • Rubin LA; Temerty Faculty of Medicine, University of Toronto, Toronto, ON; Division of Rheumatology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON.
  • Derzko-Dzulynsky LA; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON.
Can J Ophthalmol ; 2024 Jun 15.
Article en En | MEDLINE | ID: mdl-38889882
ABSTRACT

OBJECTIVE:

To study the clinical characteristics and long-term outcomes of patients with noninfectious uveitis (NIU) who are treated with systemic immunomodulatory therapy (IMT).

DESIGN:

Retrospective case series.

PARTICIPANTS:

All consecutive cases of adults with NIU under the care of 5 uveitis subspecialty tertiary care clinics between 2010 to 2021 were included.

METHODS:

Patient outcomes were assessed at initial presentation and at the latest available follow-up.

RESULTS:

A total of 418 NIU patients receiving IMT therapy with a median age of 46.0 years and 59.3% female were identified. Each patient required an average of 1.4 agents until achieving an optimal response. Following initial treatment with prednisone, patients were most commonly initiated on methotrexate. The top 3 treatments with the highest proportion of optimal treatment response when taken alone or in combination with other agents were infliximab (79.3%), cyclosporine (75%), and adalimumab (70%). The strongest predictors for requiring a greater number of IMTs trialed were younger age, panuveitis, and a chronic or recurrent disease course. Multivariable linear regression analysis suggested that baseline visual acuity at diagnosis was the only significant predictor of final visual acuity (p < 0.001).

CONCLUSIONS:

NIU patients on IMT are often trialed on multiple therapeutic agents before achieving an optimal treatment response. Visual acuity at diagnosis is a predictor of final visual outcomes, whereas chronic or recurrent disease course, younger age, and panuveitis are predictors of requiring multiagent treatment regimens.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Can J Ophthalmol Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Can J Ophthalmol Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido