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https://www.readbyqxmd.com/read/29310963/guidance-on-noncorticosteroid-systemic-immunomodulatory-therapy-in-noninfectious-uveitis-fundamentals-of-care-for-uveitis-focus-initiative
#1
REVIEW
Andrew D Dick, James T Rosenbaum, Hassan A Al-Dhibi, Rubens Belfort, Antoine P Brézin, Soon Phaik Chee, Janet L Davis, Athimalaipet V Ramanan, Koh-Hei Sonoda, Ester Carreño, Heloisa Nascimento, Sawsen Salah, Sherveen Salek, Jay Siak, Laura Steeples
TOPIC: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. CLINICAL RELEVANCE: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. METHODS: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science)...
January 5, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29303704/golimumab-in-refractory-uveitis-associated-to-juvenile-idiopathic-arthritis-multicentre-study-of-7-cases-and-literature-review
#2
REVIEW
Natalia Palmou-Fontana, Vanesa Calvo-Río, José Luis Martín-Varillas, Carlos Fernández-Díaz, Marina Mesquida, Alfredo Adán, María Victoria Hernández, Miguel Cordero-Coma, Olga Maiz Alonso, David Díaz-Valle, Carlos Fernández-Cid, Oscar Ruiz-Moreno, José Luis Hernández, Miguel Angel González-Gay, Ricardo Blanco
OBJECTIVES: To assess the efficacy of golimumab (GLM), a fully humanised anti-TNF-α monoclonal antibody, in refractory juvenile idiopathic arthritis (JIA)-associated uveitis. METHODS: This was a multicentre study of JIA-associated uveitis refractory to standard synthetic immunosuppressive drugs and in most cases to other anti-TNF-α agents. Results were expressed as mean±standard deviation or as median (range or interquartile range). The Wilcoxon signed-rank test was used to compare continuous variables...
December 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29290458/anterior-uveitis
#3
REVIEW
J Gueudry, M Muraine
Anterior Uveitis is the most common form of uveitis. There are several known and many possible etiologies for anterior uveitis. After examining the posterior segment and ruling out masquerade syndromes, the main step of etiologic diagnosis is clinical characterization. It is essential to establish the presence or absence of unilateral versus bilateral and granulomatous features. Subsequently, a directed work-up may be obtained which then helps to confirm diagnostic hypotheses based on the detailed history and clinical examination...
December 28, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29189960/a-review-of-the-landscape-of-targeted-immunomodulatory-therapies-for-non-infectious-uveitis
#4
REVIEW
Srilakshmi M Sharma, Dun Jack Fu, Kanmin Xue
Systemic immunomodulatory therapies are the principal means of managing non-infectious uveitis. This review aims to explore the current landscape of systemic uveitis treatments, including biologic therapies and the advent of biosimilar therapies.
November 30, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/29183563/a-systematic-review-and-economic-evaluation-of-adalimumab-and-dexamethasone-for-treating-non-infectious-intermediate-uveitis-posterior-uveitis-or-panuveitis-in-adults
#5
Hazel Squires, Edith Poku, Inigo Bermejo, Katy Cooper, John Stevens, Jean Hamilton, Ruth Wong, Alastair Denniston, Ian Pearce, Fahd Quhill
BACKGROUND: Non-infectious intermediate uveitis, posterior uveitis and panuveitis are a heterogeneous group of inflammatory eye disorders. Management includes local and systemic corticosteroids, immunosuppressants and biological drugs. OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness of subcutaneous adalimumab (Humira®; AbbVie Ltd, Maidenhead, UK) and a dexamethasone intravitreal implant (Ozurdex®; Allergan Ltd, Marlow, UK) in adults with non-infectious intermediate uveitis, posterior uveitis or panuveitis...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29143927/update-on-the-treatment-of-uveitis-in-patients-with-juvenile-idiopathic-arthritis-a-review
#6
REVIEW
Ioannis Asproudis, Andreas Katsanos, Nikolaos Kozeis, Alexandra Tantou, Anastasios G Konstas
Chronic uveitis is a common extra-articular manifestation of juvenile idiopathic arthritis. The classic clinical picture is one of chronic anterior uveitis, which usually remains asymptomatic until ocular complications arise. The risk of uveitis is increased in girls with an early onset of oligoarthritis and positive antinuclear antibodies. Even though the inflammation in patients with juvenile idiopathic arthritis is initially limited in the anterior part of the eye, chronic active inflammation may eventually cause significant damage to the posterior pole...
December 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29131037/paradoxical-reactions-anti-tumor-necrosis-factor-alpha-agents-ustekinumab-secukinumab-ixekizumab-and-others
#7
Lluís Puig
Paradoxical reactions during treatment with a biologic agent can be defined as the appearance or exacerbation of a pathological condition that usually responds to this class of drug while treating a patient for another condition, which usually remains under control (even though there may be a change in morphology or phenotype). Paradoxical reactions were initially described as isolated case reports or case series in patients treated with anti-tumor necrosis factor (TNF) α agents, first in inflammatory rheumatic diseases, later in psoriasis and inflammatory bowel disease...
2018: Current Problems in Dermatology
https://www.readbyqxmd.com/read/29110911/blau-syndrome-with-good-reponses-to-tocilizumab-a-case-report-and-focused-literature-review
#8
Li Lu, Min Shen, Dongbin Jiang, Yanmin Li, Xiaolong Zheng, Yao Li, Zhixun Li, Leilei Zhang, Jungen Tang, Yanke Guo, Shengyun Liu, Zhaohui Zheng, Guanmin Gao, Quancheng Kan
OBJECTIVES: Blau syndrome (BS), a rare auto-inflammatory granulomatous disease, is a progressive disorder. Usually the maintenance dose of glucocorticoid may not be tapered below 15 mg per day while immunosuppressives is used. There has been some experience with biologic agents in refractory BS patients. The objective of this study is to describe the case of a BS patient benefiting from Tocilizumab, a humanized monoclonal antibody against interleukin 6 receptor. METHODS: We report the first Chinese patient with BS who was resistant to currently available therapies but had rapid quiescence after using Tocilizumab...
September 25, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29101009/uveitis-and-juvenile-psoriatic-arthritis-or-psoriasis
#9
MULTICENTER STUDY
Sherveen S Salek, Archana Pradeep, Catherine Guly, Athimalaipet V Ramanan, James T Rosenbaum
PURPOSE: To describe the phenotype of the uveitis that accompanies juvenile psoriatic arthritis or psoriasis. DESIGN: Observational case series. METHODS: Setting: Two university-based referral clinics: 1 in England, 1 in the United States. STUDY POPULATION: Five children with uveitis and psoriatic arthritis and 1 with uveitis and psoriasis Observational Procedure: Retrospective chart review. MAIN OUTCOME MEASURES: Demographics of subjects such as age and sex; description of ocular and joint disease; surgical and other complications; medical treatment...
January 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29099660/ten-year-retention-rate-of-infliximab-in-patients-with-beh%C3%A3-et-s-disease-related-uveitis
#10
Claudia Fabiani, Jurgen Sota, Antonio Vitale, Giacomo Emmi, Lorenzo Vannozzi, Daniela Bacherini, Giuseppe Lopalco, Silvana Guerriero, Vincenzo Venerito, Ida Orlando, Rossella Franceschini, Fiorella Fusco, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Luca Cantarini
PURPOSE: To evaluate the 10-year drug retention rate of infliximab (IFX) in Behçet's disease (BD)-related uveitis, the effect of a concomitant use of disease modifying anti-rheumatic drugs (DMARDs) on drug survival and differences according to the lines of biologic treatment. METHODS: Cumulative survival rates were studied using the Kaplan-Meier plot, while the Log-rank (Mantel-Cox) test was used to compare survival curves. RESULTS: Forty patients (70 eyes) were eligible for analysis...
November 3, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29020487/clinical-characteristics-and-prognostic-factors-in-ankylosing-spondylitis-associated-uveitis
#11
Ji Hwan Lee, Moonjung Choi, Tyler Hyung Taek Rim, Sung Chul Lee, Christopher Seungkyu Lee
PURPOSE: To identify the clinical features and prognostic factors of uveitis associated with ankylosing spondylitis (AS). METHODS: This retrospective, interventional case series study reviewed the medical records of 91 AS patients with uveitis. RESULTS: The characteristics of AS-associated uveitis included male preponderance (70%), average onset in the fourth decade, unilateral manifestation (87.9%), and vitreous involvement or retinal vascular leakage (36...
October 11, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28980900/one-year-in-review-2017-beh%C3%A3-et-s-syndrome
#12
REVIEW
Gulen Hatemi, Emire Seyahi, Izzet Fresko, Rosaria Talarico, Vedat Hamuryudan
A meta-analysis showed that methodological differences in prevalence studies such as a sample survey design or census design may be responsible for some of the variance in BS prevalence reported across countries, in addition to a true geographic variation. Efforts towards developing a data driven core set of outcome measures for clinical trials is continuing. Multimodal imaging using color fundus photography, fluorescein angiography, and optical coherence tomography is essential in visualising diagnostic features, detecting structural changes, and monitoring disease activity and response to treatment in Behçet's uveitis...
September 29, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28977661/managing-morbidity-and-treatment-related-toxicity-in-patients-with-ankylosing-spondylitis
#13
Martin Bergman, Amy Lundholm
AS is the prototypical member of the family of spondyloarthropathies, and is characterized by seronegativity, axial predominance and new bone formation, which underlie symptoms of inflammatory back pain, enthesopathy and extra-articular manifestations, including anterior uveitis, psoriasis and colitis. Patients with AS typically experience a wide variety of morbidities. These include both morbidities related to the disease itself-most prominently progressive, irreversible, structural damage to the axial or peripheral skeleton-and morbidities stemming from treatments for the disease, including toxicities from NSAID use, and increased risk of infections and immunogenicity concerns with biologics...
August 4, 2017: Rheumatology
https://www.readbyqxmd.com/read/28944162/an-update-on-treatment-of-pediatric-chronic-non-infectious-uveitis
#14
Arjun B Sood, Sheila T Angeles-Han
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...
March 2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/28942074/immunosuppression-for-the-uveitides
#15
REVIEW
Douglas A Jabs
The uveitides are a collection of more than 30 diseases characterized by intraocular inflammation. Many cases of juvenile idiopathic arthritis-associated uveitis, many cases of intermediate uveitis, and most cases of posterior and panuveitides requiring treatment are treated with corticosteroids and immunosuppression. Disease-specific, time-updated modeling of clinical data for several uveitides suggests superior prevention of ocular complications and visual outcomes with immunosuppression. These studies also suggest that oral corticosteroids at doses low enough for safe long-term therapy (i...
September 20, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28844047/cumulative-retention-rate-of-adalimumab-in-patients-with-beh%C3%A3-et-s-disease-related-uveitis-a-four-year-follow-up-study
#16
Claudia Fabiani, Jurgen Sota, Antonio Vitale, Donato Rigante, Giacomo Emmi, Lorenzo Vannozzi, Daniela Bacherini, Giuseppe Lopalco, Silvana Guerriero, Stefano Gentileschi, Marco Capozzoli, Rossella Franceschini, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Luca Cantarini
BACKGROUND/AIMS: Adalimumab (ADA) has been shown to be an effective treatment for Behçet's disease (BD)-related uveitis. We aimed at evaluating the cumulative retention rate of ADA during a 48-month follow-up period in patients with BD-related uveitis, the impact of a concomitant use of disease modifying anti-rheumatic drugs (DMARDs) on ADA retention rate, and differences according to the various lines of biologic therapy (ie, first- vs second-line or more). Predictive factors of response to ADA were also investigated...
August 26, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28812149/-uveitis-in-spondyloarthritis
#17
REVIEW
M Rudwaleit, K Walscheid, A Heiligenhaus
Acute anterior uveitis (AAU) is the most frequent uveitis subtype. It is often associated with HLA-B27 and with inflammatory rheumatic diseases, in particular with spondyloarthritis (SpA), which itself is strongly associated with HLA-B27. About 40-60% of patients with AAU have an associated spondyloarthritis, and 20-40% of patients with spondyloarthritis also have uveitis. The incidence of AAU in patients with SpA clearly correlates with disease duration. The AAU has an acute onset, usually affects only one eye at a time, and shows a tendency for recurrence...
October 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28812127/-uveitis-in-juvenile-idiopathic-arthritis
#18
I Foeldvari, K Walscheid, A Heiligenhaus
BACKGROUND: Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA). It occurs, according to German registry data, in around 12% of JIA patients and can lead to a loss of vision, especially in cases of delayed diagnosis and/or inadequate therapy. OBJECTIVE: A review of current aspects of diagnosis and therapy was carried out. MATERIAL AND METHODS: This is a review article of the current literature. RESULTS: The risk of uveitis is significantly elevated in patients with an oligoarticular course of JIA, ANA positivity and young age at onset of JIA...
October 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28759560/ophthalmic-and-neuro-ophthalmic-manifestations-of-sarcoidosis
#19
REVIEW
Haben Kefella, Daniel Luther, Clotilde Hainline
PURPOSE OF REVIEW: Sarcoidosis is a multisystemic inflammatory disease that commonly affects the eye and less often the neuro-ophthalmic pathways. The manifestations can be quite variable but can have characteristic signs and clinical features. This review provides a comprehensive overview of the various ocular and neuro-ophthalmic manifestations of sarcoidosis, emerging diagnostic measures and approach to treatment. Particular focus is given to recent advances in diagnostic approach and available treatment options...
November 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28752230/biological-therapies-for-the-treatment-of-beh%C3%A3-et-s-disease-related-uveitis-beyond-tnf-alpha-blockade-a-narrative-review
#20
REVIEW
Jurgen Sota, Donato Rigante, Giuseppe Lopalco, Bruno Frediani, Rossella Franceschini, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Claudia Fabiani, Luca Cantarini
Intraocular inflammation is one of the more relevant complications of Behçet's disease (BD), which tends to respond poorly to different medications. The ocular histopathologic changes are basically identical to those occurring in other organs and consist in a necrotizing leukocytoclastic obliterative vasculitis, which is probably immune complex-mediated and affects both arteries and veins of all sizes. There are growing evidences showing the potential role of biologic agents other than anti-tumor necrosis factor (TNF)-α agents in the management of ocular-BD, which have been collected in this review, including interleukin-1 and interleukin-6 blockade, secukinumab, ustekinumab, daclizumab, rituximab, and alemtuzumab...
July 27, 2017: Rheumatology International
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