Purpose
To evaluate the outcomes of changing immunosuppressive therapy for noninfectious uveitis
after failure.
Design
Retrospective cohort study.
Participants
Patients with noninfectious uveitis managed at 2 tertiary uveitis clinics in the United
Kingdom and Australia.
Methods
Participants with a history of using immunosuppressive therapy were identified in
clinics, and notes were reviewed by doctors trained in uveitis therapy. Each treatment
episode/course (starting or changing a therapy) was identified, and demographic details,
clinical characteristics, drug used (second-line immunosuppressive agent [ISA] or
biologicals), and drug doses were obtained.
Main Outcome Measures
For each treatment episode, the reasons for changing therapy, corticosteroid-sparing
effects, and control of inflammation were determined.
Results
A total of 147 patients were identified who underwent 309 different treatment episodes.
Fifty-five percent of patients eventually required a change in treatment after their
first treatment episode/course. Forty-five episodes involved switching from one ISA
to another, with 50% to 100% of these patients achieving “success” (prednisolone ≤10
mg and sustained control) with the new ISA. A combination of ISAs were used in 53
episodes, with “success” being achieved in 50% to 71% of these patients. Biological
agents were used in 45 episodes, the most common one being infliximab, which achieved
success in 80% of patients.
Conclusions
Our data suggest that control of inflammation can be achieved after switching or combining
ISAs.
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Article Info
Publication History
Published online: January 14, 2014
Accepted:
November 18,
2013
Received in revised form:
November 16,
2013
Received:
June 11,
2013
Footnotes
Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have made the following disclosure(s): S.R.J.T. has board membership with Allergan and has received financial support for the development of educational presentations by Allergan. S.L. has board membership with Allergan and GlaxoSmithKline.
Funding: L.J. and S.R.J.T. were supported by the UK National Institute of Health Research . S.L. has received consultancy fees from PAREXEL International Corp ., Bayer, and Zeiss, and received payment for lectures and development of educational materials from Allergan .
Identification
Copyright
© 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
