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Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis

INTRODUCTION: To identify factors affecting the response rate to immunosuppressive drugs (ISDs) in patients with non-infectious uveitis (NIU). METHODS: This longitudinal retrospective cohort study included patients from the Hospital Clinico San Carlos Uveitis Clinic diagnosed with NIU from 1992 to 2...

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Autores principales: Gómez-Gómez, Alejandro, Madrid-Garcia, Alfredo, Borrego-Sanz, Lara, Álvarez-Hernández, Paula, Arriola-Villalobos, Pedro, Pérez-Sancristobal, Inés, Benítez del Castillo, José M., Mendez-Fernandez, Rosalía, Pato-Cour, Esperanza, Díaz-Valle, David, Rodriguez-Rodriguez, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834496/
https://www.ncbi.nlm.nih.gov/pubmed/36266560
http://dx.doi.org/10.1007/s40123-022-00587-8
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author Gómez-Gómez, Alejandro
Madrid-Garcia, Alfredo
Borrego-Sanz, Lara
Álvarez-Hernández, Paula
Arriola-Villalobos, Pedro
Pérez-Sancristobal, Inés
Benítez del Castillo, José M.
Mendez-Fernandez, Rosalía
Pato-Cour, Esperanza
Díaz-Valle, David
Rodriguez-Rodriguez, Luis
author_facet Gómez-Gómez, Alejandro
Madrid-Garcia, Alfredo
Borrego-Sanz, Lara
Álvarez-Hernández, Paula
Arriola-Villalobos, Pedro
Pérez-Sancristobal, Inés
Benítez del Castillo, José M.
Mendez-Fernandez, Rosalía
Pato-Cour, Esperanza
Díaz-Valle, David
Rodriguez-Rodriguez, Luis
author_sort Gómez-Gómez, Alejandro
collection PubMed
description INTRODUCTION: To identify factors affecting the response rate to immunosuppressive drugs (ISDs) in patients with non-infectious uveitis (NIU). METHODS: This longitudinal retrospective cohort study included patients from the Hospital Clinico San Carlos Uveitis Clinic diagnosed with NIU from 1992 to 2016. Subjects were followed up from ISD prescription until the achievement of good therapeutic response (GTR), ISD treatment change, or up to 12 months. GTR was defined as the complete resolution of the eye inflammatory manifestations with a corticosteroid dose ≤ 10 or ≤ 5 mg per day of prednisone or equivalent (GTR10 and GTR5, respectively) maintained for at least 28 days. Kaplan–Meier curves were estimated for GTR. Demographic, clinical, and treatment-related factors were analyzed using Cox robust regression. RESULTS: A total of 73 patients (100 episodes of ISD prescription) were analyzed. In 44 and 41 episodes, GTR10 and GTR5 were achieved, respectively. A lower hazard for both GTRs was associated with uveitic macular edema at prescription and with a higher “highest oral corticosteroid dose prescribed in the year before ISD prescription”. GTR10 was higher if cyclosporine was prescribed (compared to other ISDs), and if a higher number of ISDs had been previously prescribed. GTR5 hazard was lower for patients with posterior uveitis or if the ISDs were prescribed before 2008, and higher if periocular corticosteroids had been administered before ISD prescription, or if the duration of the posterior segment activity was shorter. CONCLUSIONS: Factors associated with GTR to ISDs may help to identify patients with NIUs who could benefit from a thorough follow-up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40123-022-00587-8.
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spelling pubmed-98344962023-01-13 Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis Gómez-Gómez, Alejandro Madrid-Garcia, Alfredo Borrego-Sanz, Lara Álvarez-Hernández, Paula Arriola-Villalobos, Pedro Pérez-Sancristobal, Inés Benítez del Castillo, José M. Mendez-Fernandez, Rosalía Pato-Cour, Esperanza Díaz-Valle, David Rodriguez-Rodriguez, Luis Ophthalmol Ther Original Research INTRODUCTION: To identify factors affecting the response rate to immunosuppressive drugs (ISDs) in patients with non-infectious uveitis (NIU). METHODS: This longitudinal retrospective cohort study included patients from the Hospital Clinico San Carlos Uveitis Clinic diagnosed with NIU from 1992 to 2016. Subjects were followed up from ISD prescription until the achievement of good therapeutic response (GTR), ISD treatment change, or up to 12 months. GTR was defined as the complete resolution of the eye inflammatory manifestations with a corticosteroid dose ≤ 10 or ≤ 5 mg per day of prednisone or equivalent (GTR10 and GTR5, respectively) maintained for at least 28 days. Kaplan–Meier curves were estimated for GTR. Demographic, clinical, and treatment-related factors were analyzed using Cox robust regression. RESULTS: A total of 73 patients (100 episodes of ISD prescription) were analyzed. In 44 and 41 episodes, GTR10 and GTR5 were achieved, respectively. A lower hazard for both GTRs was associated with uveitic macular edema at prescription and with a higher “highest oral corticosteroid dose prescribed in the year before ISD prescription”. GTR10 was higher if cyclosporine was prescribed (compared to other ISDs), and if a higher number of ISDs had been previously prescribed. GTR5 hazard was lower for patients with posterior uveitis or if the ISDs were prescribed before 2008, and higher if periocular corticosteroids had been administered before ISD prescription, or if the duration of the posterior segment activity was shorter. CONCLUSIONS: Factors associated with GTR to ISDs may help to identify patients with NIUs who could benefit from a thorough follow-up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40123-022-00587-8. Springer Healthcare 2022-10-20 2023-02 /pmc/articles/PMC9834496/ /pubmed/36266560 http://dx.doi.org/10.1007/s40123-022-00587-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Gómez-Gómez, Alejandro
Madrid-Garcia, Alfredo
Borrego-Sanz, Lara
Álvarez-Hernández, Paula
Arriola-Villalobos, Pedro
Pérez-Sancristobal, Inés
Benítez del Castillo, José M.
Mendez-Fernandez, Rosalía
Pato-Cour, Esperanza
Díaz-Valle, David
Rodriguez-Rodriguez, Luis
Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title_full Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title_fullStr Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title_full_unstemmed Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title_short Therapeutic Response After Immunosuppressive Drug Prescription in Non-infectious Uveitis: A Survival Analysis
title_sort therapeutic response after immunosuppressive drug prescription in non-infectious uveitis: a survival analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834496/
https://www.ncbi.nlm.nih.gov/pubmed/36266560
http://dx.doi.org/10.1007/s40123-022-00587-8
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