Abstract：
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.
journal_name
Ophthalmologyjournal_title
Ophthalmologyauthors
Joshi L,Talat L,Yaganti S,Sandhu S,Taylor SR,Wakefield D,McCluskey P,Lightman Sdoi
10.1016/j.ophtha.2013.11.032subject
Has Abstractpub_date
2014-05-01 00:00:00pages
1119-24issue
5eissn
0161-6420issn
1549-4713pii
S0161-6420(13)01154-8journal_volume
121pub_type
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