Quality-of-Life Metrics in Pediatric Uveitis

Angeles‐Han, Sheila T.

doi:10.1097/iio.0000000000000067

Cited by 24 publications

(10 citation statements)

References 36 publications

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“…Uveitis can have a negative impact on a child’s daily function and ability to perform visual tasks in the home and school [ 28 ]. Additionally, children need regular ophthalmology and rheumatology physician visits, phlebotomy, frequent ophthalmic drops, and systemic immunosuppressive therapy consisting of oral medications, injections and infusions.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of a cohort of children with Juvenile Idiopathic Arthritis and JIA-associated Uveitis

et al. 2015

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BackgroundJuvenile idiopathic arthritis-associated uveitis (JIA-U) can lead to poor visual outcomes and impact a child’s quality of life (QOL) and function. Our aim is to identify risk markers of JIA-U and examine differences in the QOL of children with JIA and JIA-U.MethodsRheumatology and ophthalmology record reviews and questionnaires were completed every 4–6 months on 287 children with JIA. We collected arthritis, uveitis, and QOL data. We examined data through last study visit.ResultsThere were 52/287 (18 %) children with JIA-U who were younger at arthritis diagnosis, had oligoarticular persistent JIA, and ANA positive. Confirmed uveitis predictors were age at JIA diagnosis (OR = 0.86) and oligoarticular subtype (OR = 5.92). They had worse vision specific QOL and function, but similar general QOL. Blindness occurred in 17.5 % of children but was more common in African American children compared to non-Hispanic Caucasian children ((5/7 (71 %) vs. 2/29 (7 %), p <0.001) despite a similar uveitis prevalence (22 % vs. 16 %). Both races had similar complications, although band keratopathy was more frequent in African Americans (75 % vs. 15.6 %, p = 0.003).ConclusionsWe confirm young age at JIA diagnosis and the oligoarticular JIA subtype as predictors of uveitis development. Although we were unable to identify predictors of ocular complications or blindness, AA children appeared to have a more severe disease course manifested by increased ocular complications, vision loss and blindness. Potential causes that warrant additional study include underlying disease severity, access to medical care and referral bias. Further investigation of the risk factors for vision-compromising uveitis and its’ long-term effects should be conducted in a large racially diverse population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12969-015-0018-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Characteristics of a cohort of children with Juvenile Idiopathic Arthritis and JIA-associated Uveitis

et al. 2015

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“…There is a lack of instruments that measure vision-related function and QOL in children overall 24 . There is no questionnaire specifically for pediatric uveitis despite the well-established need for disease-focused instruments.…”

Section: Discussionmentioning

confidence: 99%

Using the Effects of Youngsters’ Eyesight on Quality of Life Questionnaire to Measure Visual Outcomes in Children With Uveitis

Angeles‐Han

Yeh

McCracken

et al. 2015

Arthritis Care & Research

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Objective The Effects of Youngsters’ Eyesight on Quality of Life (EYE-Q) is a novel measure of vision-related quality of life (QOL) and function in children. We aim to determine the validity of EYE-Q in childhood uveitis. Methods We abstracted medical record data on arthritis and uveitis in a convenience sample of children with juvenile idiopathic arthritis (JIA) and/or uveitis. In addition to the EYE-Q, parents and patients completed questionnaires on overall QOL (Pediatric QOL Inventory - PedsQL), and physical functioning (Childhood Health Assessment Questionnaire - CHAQ). Results Among 57 children (8 JIA, 24 JIA and uveitis, 25 uveitis alone), 102 ocular examinations were performed within 1 month of completing questionnaires. Uveitis patients had bilateral disease (69%), anterior involvement (78%), synechiae (51%) and cataracts (49%). Children with vision loss in their better eye (visual acuity (VA) 20/50 or worse) had worse EYE-Q (p = 0.006), and PedsQL (p = 0.028), but not CHAQ scores. The EYE-Q moderately correlated with logMAR VA (rs = −0.43), PedsQL (rs = 0.43) and CHAQ (rs = −0.45), but was not correlated with anterior chamber cells or intraocular pressure. The PedsQL and CHAQ did not correlate with VA or cells. There were strong correlations between the parent and child EYE-Q (rs = 0.62). Cronbach's α for the child report was 0.91. The EYE-Q had strong test-retest reliability (rs=0.75). Conclusion The EYE-Q may be an important tool in the assessment of visual outcomes in childhood uveitis and an improvement over general measures in detecting changes in vision-related function.

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“…56 A raft of secondary end-points including disease activity markers, anatomical and functional outcomes, and QoL were included. QoL measures are considered of particular relevance to patients with uveitis, 57–59 who may otherwise be exposed to prolonged courses of local/systemic corticosteroid treatment and have multiple related co-morbidities. In addition, the nature of systemic treatment with biologic agents such as adalimumab, themselves associated with systemic adverse effects, renders QoL particularly important in assessing patient benefits over and above those obtained by treatment on the local ocular disease activity.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic medicine regulatory approvals through the European Centralised Procedure, 1999–2017: Clinical efficacy considerations

Morgan-Warren¹

2019

European Journal of Ophthalmology

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Objectives: Regulatory approval of new medicines requires a thorough assessment of the potential clinical benefits and risks. Study end-points are expected to demonstrate a clinically relevant treatment effect that will translate into direct patient benefits. This study sought to review the ophthalmic medicines with European Union–wide approval granted via the Centralised Procedure and characterise the key efficacy end-points underpinning the demonstration of clinical benefit. Methods: This study was a retrospective review of published data pertaining to the European regulatory authorisation of centrally approved ophthalmic products between 1999 and 2017, inclusive. All sources and data consulted are in the public domain. European Public Assessment Reports published by the European Medicines Agency were consulted for data concerning the pivotal clinical efficacy studies supporting the applications. Data analyses were descriptive. Results: The European Medicines Agency have authorised 30 products via the Centralised Procedure between 1999 and 2017. For these products, a total of 24 additional approvals for line extensions or additional therapeutic indications were granted. Four products have been approved for orphan indications, including one approval ‘under exceptional circumstances’ and one ‘Conditional Marketing Authorisation’. Approvals for products in retina (36%) and glaucoma (28%) indications together accounted for the majority of authorisations, with trial end-points predominantly based on visual acuity and intraocular pressure parameters, respectively. Products were also approved for indications in ocular surface disease, inflammation, optic neuropathy and surgical adjuncts, with a range of functional and anatomical end-points. Conclusion: Approvals for ophthalmic medicines have been granted for a range of clinical indications, representing a considerable portion of available major therapeutics for practitioners. Benefit–risk assessments rely on clinical trial data demonstrating a clearly relevant patient benefit.

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Quality-of-Life Metrics in Pediatric Uveitis

Cited by 24 publications

References 36 publications

Characteristics of a cohort of children with Juvenile Idiopathic Arthritis and JIA-associated Uveitis

Characteristics of a cohort of children with Juvenile Idiopathic Arthritis and JIA-associated Uveitis

Using the Effects of Youngsters’ Eyesight on Quality of Life Questionnaire to Measure Visual Outcomes in Children With Uveitis

Ophthalmic medicine regulatory approvals through the European Centralised Procedure, 1999–2017: Clinical efficacy considerations

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