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Corticosteroid-sparing therapy: practice patterns among uveitis specialists.

Esterberg E, Acharya NR - J Ophthalmic Inflamm Infect (2011)

Bottom Line: Topics included effectiveness, usage, and preferences related to seven immunomodulatory treatments.Primary reasons not to prescribe a treatment were effectiveness for azathioprine, safety/tolerability for cyclosporine and cyclophosphamide, and a mixture of cost, safety/tolerability, and difficulty of administration for the biologic drugs.Although newer biologic drugs are seen as effective, they are not commonly used, or even preferred, as initial corticosteroid-sparing treatment.

View Article: PubMed Central - PubMed

Affiliation: F.I. Proctor Foundation, University of California San Francisco, Room S309, 513 Parnassus Avenue, San Francisco, CA, 94143-0412, USA.

ABSTRACT

Purpose: This study aims to determine uveitis specialists' practice patterns, preferences, and perceptions of corticosteroid-sparing therapies for the initial treatment of chronic noninfectious uveitis.

Methods: A survey was distributed to the American Uveitis Society and Proctor email listservs in order to restrict the respondents to specialists who likely have extensive experience in the use of immunomodulatory therapy. Topics included effectiveness, usage, and preferences related to seven immunomodulatory treatments.

Results: Among the 45 responders, the majority (59%) had greater than 10 years of experience treating uveitis. Methotrexate was the most commonly used initial therapy for anterior, intermediate, and posterior/panuveitis (85%, 57%, and 37%), and the most preferred for anterior (55%). Mycophenolate mofetil was the most preferred for intermediate (35%) and posterior/panuveitis (42%). Primary reasons not to prescribe a treatment were effectiveness for azathioprine, safety/tolerability for cyclosporine and cyclophosphamide, and a mixture of cost, safety/tolerability, and difficulty of administration for the biologic drugs.

Conclusions: Within the group of highly experienced uveitis specialists, methotrexate is still the most commonly used initial treatment. Although newer biologic drugs are seen as effective, they are not commonly used, or even preferred, as initial corticosteroid-sparing treatment.

No MeSH data available.


Related in: MedlinePlus

Histograms showing proportions of respondents, with 95% onfidence intervals, ranking each treatment as most commonly used or most preferred if cost and availability were not an issue. MTX methotrexate, MMF mycophenolate mofetil, AZA azathioprine, CSA cyclosporine, CTX cyclophosphamide, INF infliximab, ADA adalimumab
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Fig1: Histograms showing proportions of respondents, with 95% onfidence intervals, ranking each treatment as most commonly used or most preferred if cost and availability were not an issue. MTX methotrexate, MMF mycophenolate mofetil, AZA azathioprine, CSA cyclosporine, CTX cyclophosphamide, INF infliximab, ADA adalimumab

Mentions: The majority of respondents reported that methotrexate was their most commonly used initial corticosteroid-sparing treatment for noninfectious uveitis in all three anatomic subgroups, followed by mycophenolate mofetil (85% vs. 6% for anterior, P < 0.001; 57% vs. 22% for intermediate, P = 0.002; 37% vs. 27% for posterior/panuveitis, P = 0.49) (see Fig. 1). Azathioprine, cyclophosphamide, and infliximab were rarely or never used as initial corticosteroid-sparing treatment, and none of the respondents listed adalimumab as being used for initial treatment for any anatomic subgroup.Fig. 1


Corticosteroid-sparing therapy: practice patterns among uveitis specialists.

Esterberg E, Acharya NR - J Ophthalmic Inflamm Infect (2011)

Histograms showing proportions of respondents, with 95% onfidence intervals, ranking each treatment as most commonly used or most preferred if cost and availability were not an issue. MTX methotrexate, MMF mycophenolate mofetil, AZA azathioprine, CSA cyclosporine, CTX cyclophosphamide, INF infliximab, ADA adalimumab
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3302992&req=5

Fig1: Histograms showing proportions of respondents, with 95% onfidence intervals, ranking each treatment as most commonly used or most preferred if cost and availability were not an issue. MTX methotrexate, MMF mycophenolate mofetil, AZA azathioprine, CSA cyclosporine, CTX cyclophosphamide, INF infliximab, ADA adalimumab
Mentions: The majority of respondents reported that methotrexate was their most commonly used initial corticosteroid-sparing treatment for noninfectious uveitis in all three anatomic subgroups, followed by mycophenolate mofetil (85% vs. 6% for anterior, P < 0.001; 57% vs. 22% for intermediate, P = 0.002; 37% vs. 27% for posterior/panuveitis, P = 0.49) (see Fig. 1). Azathioprine, cyclophosphamide, and infliximab were rarely or never used as initial corticosteroid-sparing treatment, and none of the respondents listed adalimumab as being used for initial treatment for any anatomic subgroup.Fig. 1

Bottom Line: Topics included effectiveness, usage, and preferences related to seven immunomodulatory treatments.Primary reasons not to prescribe a treatment were effectiveness for azathioprine, safety/tolerability for cyclosporine and cyclophosphamide, and a mixture of cost, safety/tolerability, and difficulty of administration for the biologic drugs.Although newer biologic drugs are seen as effective, they are not commonly used, or even preferred, as initial corticosteroid-sparing treatment.

View Article: PubMed Central - PubMed

Affiliation: F.I. Proctor Foundation, University of California San Francisco, Room S309, 513 Parnassus Avenue, San Francisco, CA, 94143-0412, USA.

ABSTRACT

Purpose: This study aims to determine uveitis specialists' practice patterns, preferences, and perceptions of corticosteroid-sparing therapies for the initial treatment of chronic noninfectious uveitis.

Methods: A survey was distributed to the American Uveitis Society and Proctor email listservs in order to restrict the respondents to specialists who likely have extensive experience in the use of immunomodulatory therapy. Topics included effectiveness, usage, and preferences related to seven immunomodulatory treatments.

Results: Among the 45 responders, the majority (59%) had greater than 10 years of experience treating uveitis. Methotrexate was the most commonly used initial therapy for anterior, intermediate, and posterior/panuveitis (85%, 57%, and 37%), and the most preferred for anterior (55%). Mycophenolate mofetil was the most preferred for intermediate (35%) and posterior/panuveitis (42%). Primary reasons not to prescribe a treatment were effectiveness for azathioprine, safety/tolerability for cyclosporine and cyclophosphamide, and a mixture of cost, safety/tolerability, and difficulty of administration for the biologic drugs.

Conclusions: Within the group of highly experienced uveitis specialists, methotrexate is still the most commonly used initial treatment. Although newer biologic drugs are seen as effective, they are not commonly used, or even preferred, as initial corticosteroid-sparing treatment.

No MeSH data available.


Related in: MedlinePlus