Dexamethasone intravitreal implant (Ozurdex) for the treatment of pediatric uveitis

Bratton, Monica L.; He, Yu Guang; Weakley, David R.

doi:10.1016/j.jaapos.2013.11.014

Cited by 32 publications

(13 citation statements)

References 14 publications

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“…Longer duration intraocular therapy includes Dexamethasone implant (Ozurdex) and 0.59 mg Fluocinolone acetonide implant (Retisert)(23–28). Ozurdex implantation lasts 6 months whereas Retisert implantation lasts for nearly 3 years, which reduces the overall risk associated with anesthesia compared to repeat TA injections (24, 26). An emerging option is a 0.19mg Fluocinolone acetonide injectable (Illuvien) that was FDA approved for the management of diabetic retinopathy.…”

Section: Treatmentmentioning

confidence: 99%

“…Intravenous (IV) corticosteroids are occasionally used in cases of severe ocular inflammation, including Behcet’s disease, serpiginous choroiditis, or uveitis with optic nerve involvement (2). However, long-term use of systemic steroids has potential adverse effects in the pediatric patient that include growth retardation, hyperglycemia, weight gain, hypertension, osteoporosis, peptic ulcers, cataracts and glaucoma (23, 24). …”

Section: Treatmentmentioning

confidence: 99%

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An Update on Treatment of Pediatric Chronic Non-infectious Uveitis

Sood

Angeles‐Han

2017

Curr Treat Options in Rheum

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Opinion Statement There are no standardized treatment protocols for pediatric non-infectious uveitis. Topical corticosteroids are the typical first-line agent, although systemic corticosteroids are used in intermediate, posterior and panuveitic uveitis. Corticosteroids are not considered to be long-term therapy due to potential ocular and systemic side effects. In children with severe and/or refractory uveitis, timely management with higher dose disease-modifying antirheumatic drugs (DMARDs) and biologic agents is important. Increased doses earlier in the disease course may lead to improved disease control and better visual outcomes. In general, methotrexate is the usual first-line steroid-sparing agent and given as a subcutaneous weekly injection at >0.5 mg/kg/dose or 10–15 mg/m2 due to better bioavailability. Other DMARDs, for instance mycophenolate, azathioprine, and cyclosporine are less common treatments for pediatric uveitis. Anti-tumor necrosis factor-alpha agents, primarily infliximab and adalimumab are used as second line agents in children refractory to methotrexate, or as first-line treatment in those with severe complicated disease at presentation. Infliximab may be given at a minimum of 7.5 mg/kg/dose every 4 weeks after loading doses, up to 20 mg/kg/dose. Adalimumab may be given up to 20 or 40 mg weekly. In children who fail anti-tumor necrosis factor-alpha agents, develop anti-tumor necrosis factor-alpha antibodies, experience adverse effects, or have difficulty with tolerance, there is less data available regarding subsequent treatment. Promising results have been noted with tocilizumab infusions every 2–4 weeks, abatacept monthly infusions and rituximab.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

An Update on Treatment of Pediatric Chronic Non-infectious Uveitis

Sood

Angeles‐Han

2017

Curr Treat Options in Rheum

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“…Bratton et al reported that dexamethasone implants, in combination with systemic immunomodulatory therapy, resulted in improved visual acuity, control of intraocular inflammation, and a decrease in corticosteroid use during the treatment of pediatric uveitis 30 . The uveitis reoccurred in 57% of eyes at 4.3 months (range of 2–7 months) after injection.…”

Section: Corticosteroid Implantsmentioning

confidence: 99%

Recent advances in managing and understanding uveitis

Chen

Sheu

2017

F1000Res

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Uveitis is a sight-threatening disease entity with intraocular inflammation that arises from various causes. It mainly affects working-age individuals and may lead to irreversible visual loss if not treated properly in a timely manner. This article reviews recent advances in the management and understanding of uveitis since 2014, including treatment with new immunosuppressive therapies that use biological agents, local therapy with steroid implants, and imaging studies for the evaluation of uveitis.

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“…DEX implant has also been reported to be effective in treating persistent macular edema resistant to other therapy in quiescent intermediate and posterior uveitis and to be useful in the treatment of pediatric uveitis …”

Section: Postmarketing Studiesmentioning

confidence: 99%

Development of a dexamethasone intravitreal implant for the treatment of noninfectious posterior segment uveitis

Whitcup

Robinson

2015

Annals of the New York Academy of Sciences

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Uveitis is a group of ocular inflammatory disorders that can lead to severe vision loss. Despite advances in antiinflammatory therapy, many patients are resistant to or intolerant of existing treatments. A biodegradable, sustainedrelease implant, dexamethasone intravitreal implant 0.7 mg (Ozurdex), has been developed to deliver dexamethasone to target tissues in the posterior segment of the eye, minimizing systemic drug exposure and limiting side effects. The implant releases dexamethasone over a period of up to 6 months as the poly(d,l-lactide-co-glycolide) polymer matrix of the implant is metabolized to carbon dioxide and water. The implant is placed in the vitreous of the eye with a single-use applicator in a sutureless, office-based procedure. Treatment with a single dexamethasone intravitreal implant in patients with noninfectious intermediate or posterior uveitis has been shown to produce significant improvements in intraocular inflammation and best-corrected visual acuity with treatment benefit sustained for 6 months. Dexamethasone intravitreal implant has also been shown to reduce central retinal thickness and improve best-corrected visual acuity in patients with macular edema of various etiologies. The implant has been approved for treatment of noninfectious uveitis involving the posterior segment, diabetic macular edema, and macular edema associated with branch and central retinal vein occlusion.

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Dexamethasone intravitreal implant (Ozurdex) for the treatment of pediatric uveitis

Cited by 32 publications

References 14 publications

An Update on Treatment of Pediatric Chronic Non-infectious Uveitis

An Update on Treatment of Pediatric Chronic Non-infectious Uveitis

Recent advances in managing and understanding uveitis

Development of a dexamethasone intravitreal implant for the treatment of noninfectious posterior segment uveitis

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