Burden and Direct Costs of Non Infectious Uveitis in Spain

Adán-Civera, Alfredo; Benítez-del-Castillo, J.M.; Blanco-Alonso, Ricardo; Pato-Cour, Esperanza; Sellas-Fernández, A.; Bañares-Cañizares, Antonio

doi:10.1016/j.reumae.2016.04.003

Cited by 12 publications

(11 citation statements)

References 11 publications

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“…Singapur [10] Spanien [13] Österreich [7] Schweiz [8,9] anteriore Uveitis 55,9 % 55 % 59,9 % 47-61 % [37,40]. Sekundär entscheiden die differenzialdiagnostische Einordnung und der tägliche Steroidbedarf nach der Stabilisierung der akuten Erkrankung über die Wahl immunmodulierender Therapien [36] mit dem Ziel, das Risiko von Therapienebenwirkungen, z.…”

Section: Lokalisationunclassified

Diagnostische Strategie und therapeutisches Dilemma bei akuter posteriorer und Panuveitis

Garweg

Messerli

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungDie breite Differenzialdiagnose der akuten posterioren und Panuveitis, die meist jüngere Individuen und in mehr als der Hälfte beide Augen betrifft, macht die rasche diagnostische Einordnung und die therapeutische Entscheidung wegen ihrer erheblichen Konsequenzen für den weiteren Verlauf zu kritischen Schritten. Das Risiko eines bleibenden Visusverlustes infolge eines verzögerten Therapiebeginns ist dabei ebenso bedeutsam wie das Einleiten einer nicht genügend wirksamen Therapie. Klinische Präsentation (anatomische Lokalisation und Entzündungstyp), Verlauf und sekundär das Ansprechen auf die Akuttherapie lassen eine erste diagnostische Eingrenzung zu, wobei eine infektiöse Ätiologie in bis zu einem Drittel der Fälle vorliegt. Die häufigste akute posteriore Uveitis bei immunkompetenten Patienten ist eine akute virale Netzhautnekrose. Diese lässt sich oft klinisch nicht sicher von einer Behçet-Uveitis unterscheiden, solange keine systemischen Manifestationen vorliegen. Bis zur definitiven diagnostischen Einordnung muss deshalb bei makulabedrohender Erkrankung spätestens 24 Stunden nach Beginn einer antiviralen und antiparasitären Akuttherapie eine hochdosierte Steroidtherapie begonnen werden. Den therapeutischen Konsequenzen der Fehleinschätzung der Erkrankung stehen prognostische Überlegungen gegenüber, die ein aggressives Vorgehen gerade bei akuten posterioren Uveitiden rechtfertigen: Jede Verzögerung des Therapiebeginns vermehrt die infektiöse und entzündliche Gewebsschädigung, erhöht das Risiko einer Affektion des Partnerauges und anderer Organe, wohingegen der Einsatz höherer Steroiddosen, Immunsuppressiva und Biologika zu unkontrollierter Erregerproliferation und zu Rezidiven führen kann.

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Section: Lokalisationunclassified

Diagnostische Strategie und therapeutisches Dilemma bei akuter posteriorer und Panuveitis

Garweg

Messerli

2019

Klin Monatsbl Augenheilkd

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“…Additionally, a high percentage of patients suffer from uveitis-related complications, visual impairment4 7 8 and a negative impact in quality-of-life (QoL) 9 10. Considering their higher prevalence in young to middle-aged adults,11 12 uveitides cause an important economic, social and personal burden 5 13–16…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety and cost-effectiveness of methotrexate, adalimumab or their combination in non-infectious non-anterior uveitis: a protocol for a multicentre, randomised, parallel three arms, active-controlled, phase III open label with blinded outcome assessment study

et al. 2022

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IntroductionNon-infectious uveitis include a heterogeneous group of sight-threatening and incapacitating conditions. Their correct management sometimes requires the use of immunosuppressive drugs (ISDs), prescribed in monotherapy or in combination. Several observational studies showed that the use of ISDs in combination could be more effective than and as safe as their use in monotherapy. However, a direct comparison between these two treatment strategies has not been carried out yet.Methods and analysisThe Combination THerapy with mEthotrexate and adalImumAb for uveitis (CoTHEIA) study is a phase III, multicentre, prospective, randomised, single-blinded with masked outcome assessment, parallel three arms with 1:1:1 allocation, active-controlled, superiority study design, comparing the efficacy, safety and cost-effectiveness of methotrexate, adalimumab or their combination in non-infectious non-anterior uveitis. We aim to recruit 192 subjects. The duration of the treatment and follow-up will last up to 52 weeks, plus 70 days follow-up with no treatment. The complete and maintained resolution of the ocular inflammation will be assessed by masked evaluators (primary outcome). In addition to other secondary measurements of efficacy (quality of life, visual acuity and costs) and safety, we will identify subjects’ subgroups with different treatment responses by developing prediction models based on machine learning techniques using genetic and proteomic biomarkers.Ethics and disseminationThe protocol, annexes and informed consent forms were approved by the Reference Clinical Research Ethic Committee at the Hospital Clínico San Carlos (Madrid, Spain) and the Spanish Agency for Medicines and Health Products. We will elaborate a dissemination plan including production of materials adapted to several formats to communicate the clinical trial progress and findings to a broad group of stakeholders. The promoter will be the only access to the participant-level data, although it can be shared within the legal situation.Trial registration number2020-000130-18; NCT04798755.

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“…Blindness caused by uveitis is potentially treatable. Furthermore, with a majority of patients in the working-age group, the impact on the quality of life and the potential social and economic costs are tremendous [6,7].…”

Section: Introductionmentioning

confidence: 99%

Impact of Ocular Complications on Visual Outcomes in Adult Patients With Uveitis

Cura¹,

González-Guijarro²

2022

Cureus

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BackgroundIn this study, we aimed to assess the impact of ocular complications on visual outcomes in uveitis. MethodologyWe conducted a retrospective cohort study of 474 uveitis patients (655 eyes) with a mean age of 52.4 years who were followed for a median of 32 months (range: 8-80 months). ResultsAt least one ocular complication was found in 317 eyes (48.4%), 161 of which were present at the time of diagnosis (prevalent complication). Although having an ocular complication was associated with a mean loss of 1.7 Early Treatment Diabetic Retinopathy Study (ETDRS) lines, the best-corrected visual acuity increased at the end of the study. Complications causing a decrease of ≥2 ETDRS lines were prevalent macular and peripheral retinal diseases, as well as new-onset corneal lesions, intraocular pressure alterations, and peripheral retinal diseases. ConclusionsThe impact of the most frequent complications (cataract and macular edema) did not reach two ETDRS lines. Macular diseases at presentation were the main risk factor for visual loss at the end of follow-up.

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Burden and Direct Costs of Non Infectious Uveitis in Spain

Cited by 12 publications

References 11 publications

Diagnostische Strategie und therapeutisches Dilemma bei akuter posteriorer und Panuveitis

Diagnostische Strategie und therapeutisches Dilemma bei akuter posteriorer und Panuveitis

Efficacy, safety and cost-effectiveness of methotrexate, adalimumab or their combination in non-infectious non-anterior uveitis: a protocol for a multicentre, randomised, parallel three arms, active-controlled, phase III open label with blinded outcome assessment study

Impact of Ocular Complications on Visual Outcomes in Adult Patients With Uveitis

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