Article Text
Abstract
Background Non-infectious uveitis is a diverse group of inflammatory conditions that collectively account for substantial blindness worldwide. Expert guidelines and results of clinical trials guide treatment, but real-world clinical care is impacted by additional factors. In 2023, an international group of uveitis-specialised ophthalmologists formed the International Study Group for Systemic Immunomodulatory Drug Treatment of Non-Infectious Uveitis to report current practice.
Methods 221 study group members from 53 countries completed a 30-item questionnaire on their management of non-infectious uveitis including: indications for and investigations prior to initiating systemic immunomodulatory drugs, use of conventional and biological drugs, and follow-up of treated patients.
Results Major indications to initiate systemic immunomodulatory drugs were: uveitis not controlled with oral prednis(ol)one (n=208, 94.1%), specific uveitis diagnosis (n=197, 89.1%), and patient intolerance of oral prednis(ol)one (n=186, 84.2%). All members (n=221, 100%) performed pretreatment screens including: blood chemistry (n=217, 98.2%), blood examination (n=207, 93.7%), and Quantiferon assay (n=196, 88.7%). Eight conventional and 14 biological drugs were prescribed: methotrexate was the preferred conventional drug overall (n=126, 57.0%) and for 9 of 11 uveitides, and adalimumab was the preferred biological drug overall (n=216, 97.7%) and for 11 of 11 uveitides. When drugs were combined, methotrexate plus adalimumab was most popular (n=158 of 188 members, 84.0%). Patients with inactive uveitis were typically evaluated and screened for drug toxicity every 6–12 weeks (n=161, 72.9%, and 165, 74.7%, respectively).
Conclusion Our report describes practice patterns of a large international group of uveitis specialists treating non-infectious uveitis with systemic immunomodulatory drugs.
- Uveitis
- Treatment other
- Drugs
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Collaborators International Study Group for Systemic Immunomodulatory Drug Treatment of Non‐Infectious Uveitis: Jessica M Abaño (Taguig City, Philippines), Sara Abdel Jalil (Nablus, Palestine), Alaa D Abdin (Homburg, Germany), Massimo Accorinti (Rome, Italy), Aniruddha Agarwal (Abu Dhabi, United Arab Emirates), Jorge A Aguilera-Partida (Guadalajara, Mexico), Jasmin Ahmad (Chattagram, Bangladesh), Carlos Alvarez-Guzman (Monterrey, Mexico), Radgonde Amer (Jerusalem, Israel), Cesar Arrieta-Bechara (Cadiz, Spain), Pedro Arriola-Villalobos (Madrid, Spain), Jose Carlo M Artiaga (Manila City, Philippines), Yulia Aziza (Jakarta, Indonesia), Kalpana Babu (Bengaluru, India), Dina Baddar (Cairo, Egypt), Jeonghun Bae (Seoul, Republic of Korea/South Korea), Dmitrii Bagautdinov (Heidelberg, Germany), Alay Banker (Ahmedabad, India), Reema Bansal (Chandigarh, India), Nieves Pardiñas Barón (Zaragoza, Spain), Matthias Becker (Zürich, Switzerland), Meghan Berkenstock (Baltimore, USA), Eric Kirkegaard Biosca (Barcelona, Spain), Jyotirmay Biswas (Chennai, India), Bahram Bodaghi (Paris, France), Julien Bouleau (Lille, France), Tasanee Braithwaite (London, United Kingdom), Christopher Brand (Sheffield, United Kingdom), María J Capella (Barcellona, Spain), Ester Carreño (Madrid, Spain), Anita Chan (Singapore, Singapore), Wei-Chun Chan (Taipei, Taiwan), Yo-Chen Chang (Kaohsiung, Taiwan), José Javier Chavarri García (Logroño, Spain), Soon-Phaik Chee (Singapore, Singapore), Rashel Cheja-Kalb (Mexico City, Mexico), Fred K Chen (Perth, Australia), Yi-Hsing Chen (Taipei, Taiwan), Colin Chu (London, United Kingdom), Yoo-Ri Chung (Suwon, Republic of Korea/South Korea), Andrius Cimbalas (Vilnius, Lithuania), Luca Cimino (Reggio Emilia, Italy), Lidia Cocho (Valladolid, Spain), Luz E Concha-del-Rio (Mexico City, Mexico), Diana Conrad (Brisbane, Australia), Dipankar Das (Guwahati, India), Gábor G Deák (Vienna, Austria), Alejandra de-la-Torre (Bogotá, Colombia), Cristian de los Santos (Santo Domingo, Dominican Republic), Maria del Mar Esteban-Ortega (Madrid, Spain), Christoph Deuter (Tuebingen, Germany), Sanjeev K Dhoot (Bathinda, India), Mohit Dogra (Chandigarh, India), Oleksandra Dorokhova (Odesa, Ukraine), Deshka Doycheva (Tuebingen, Germany), Gonzalo Duarte (Viña del Mar, Chile), Khayyam Durrani (Farmington, USA), Parthopratim Dutta Majumder (Chennai, India), Lukman Edwar (Jakarta, Indonesia), Denisova Ekaterins (Moscow, Russia), Parisa Emami-Naeini (Sacramento, USA), Marie-Helene Errera (Pittsburgh, USA), Claudia Fabiani (Siena, Italy), Jarmila Fabianová (Tatranská Štrba, Slovakia), Jordan Famadico (Lipa City, Philippines), Anselmo Feliciano-Sánchez (Valencia, Spain), Luis Figueira (Porto, Portugal), Alex Fonollosa (Cruces-Barakaldo, Spain), Samantha Fraser-Bell (Sydney, Australia), Atsuki Fukushima (Himeji, Japan), Sapna Gangaputra (Nashville, USA), Cristina Garcia (Metro Manila, Philippines), M Marcela Garcia (Buenos Aires, Argentina), Justus Garweg (Bern, Switzerland), Zsuzsanna Gehl (Budapest, Hungary), Marcelo L Gehlen (Curitiba, Brazil), Giuseppe Giannaccare (Cagliari, Italy), Alex Giménez (Girona, Spain), Debra A. Goldstein (Chicago, USA), Julio J Gonzalez-Lopez (Madrid, Spain), Fabrizio Gozzi (Reggio Emilia, Italy), Julie Gueudry (Rouen, France), Konstantin Gugleta (Basel, Switzerland), Vishali Gupta (Chandigarh, India), Avinash Gurbaxani (London, United Kingdom), Zohar Habot-Wilner (Tel Aviv, Israel), Anthony Hall (Melbourne, Australia), Noriyasu Hashida (Suita, Japan), Carsten Heinz (Münster, Germany), Jarmila Heissigerova (Prague, Czech Republic), Marisa Hernández (Valencia, Spain), Rodrigo P Hormazábal (Concepción, Chile), Homaira A Hossain (Atlanta, USA), Edward Hughes (Brighton, United Kingdom), De-Kuang Hwang (Taipei, Taiwan), Tajunisah Iqbal (Kuala Lumpur, Malaysia), Salam Iriqat (Jerusalem, Palestine), Shah M Bulbul Islam (Dhaka, Bangladesh), Maria Jerez (Badajoz, Spain), Margarita Jódar-Márquez (Málaga, Spain), Toshikatsu Kaburaki (Saitama, Japan), Yutaka Kaneko (Yamagata, Japan), Tzu-En Kao (Kaohsiung, Taiwan), Eva Karlsson (Örebro, Sweden), Hiroshi Keino (Tokyo, Japan), Narumon Keorochana (Bangkok, Thailand), Moncef Khairallah (Monastir, Tunisia), Chansathya Khieu (Phnom Penh, Cambodia), Bo Hee Kim (Seoul, Republic of Korea/South Korea), Min Kim (Seoul, Republic of Korea/South Korea), Sentaro Kusuhara (Kobe, Japan), Timothy YY Lai (Kowloon, Hong Kong), Ines Leal (Lisboa, Portugal), Christopher S Lee (Seoul, Republic of Korea/South Korea), Pierre Lefebvre (Brussels, Belgium), Sanna Leinonen (Tampere, Finland), Andrea Leonardi (Padova, Italy), Lyndell Lim (Melbourne, Australia), Víctor Llorenç (Barcelona, Spain), Juan S Lopez (Quezon City, Philippines), Zahra Mahdizad (Tehran, Iran), Mohammad IA Malek (Dhaka, Bangladesh), Clara Martínez-Rubio (Valencia, Spain), Helene Masse (Nantes, France), Wataru Matsumiya (Kobe, Japan), Ilhem Mili-Boussen (Tunis, Tunisia), Manabu Mochizuki (Tokyo, Japan), Shelina O. Mohamed (Selangor, Malaysia), Phoebe Moore (Tamworth, Australia), Alessandro Marchese (Milan, Italy), Samyak Mulkutkar (Mumbai, India), Conor C. Murphy (Dublin, Ireland), Philip I Murray (Birmingham, United Kingdom), Nakhoul Nakhoul (Shefaram, Israel), Kenichi Namba (Sapporo, Japan), Piergiorgio Neri (Abu Dhabi, United Arab Emirates), Yaninsiri Ngathaweesuk (Bangkok, Thailand), Annabelle A Okada (Tokyo, Japan), Narciss Okhravi (London, United Kingdom), Neil GL Onghanseng (Makati, Philippines), Gabriela Ortega-Larrocea (Mexico City, Mexico), Pinar C Ozdal (Ankara, Turkey), Alan G Palestine (Aurora, USA), Jelena Paovic (Belgrade, Serbia), Thekla Papadaki (Athens, Greece), Ian P Paredes (Mandaluyong, Philippines), Young-Hoon Park (Seoul, Republic of Korea/South Korea), Maria P Paroli (Rome, Italy), Eduard Pedemonte-Sarrias (Barcelona, Spain), Francesco Pichi (Abu Dhabi, United Arab Emirates), M Francisca Pina Perez (Murcia, Spain), Uwe Pleyer (Berlin, Germany), Guillem Policarpo Torres (Girona, Spain), Aleksandra Radosavljevic (Belgrade, Serbia), M Zahedur Rahman (Dhaka, Bangladesh), Russell W. Read (Birmingham, USA), Irene Redondo (Madrid, Spain), Ramūnas Riauka (Vilnius, Lithuania), Josephine Richards (Perth, Australia), Alejandro Rodriguez-Garcia (Monterrey, Mexico), Matilde Ruiz-Cruz (Mexico City, Mexico), Ali Osman Saatci (İzmir, Turkey), Pablo Sabat (Santiago, Chile), Maite Sainz-de-la-Maza (Barcelona, Spain), Priya Samalia (Dunedin, New Zealand), Juan L Sánchez Sevila (Alicante, Spain), Rajasudha Sawri Rajan (Kuala Lumpur, Malaysia), Shaul Sar (Haifa, Israel), Pieter-Paul Schauwvlieghe (Antwerp, Belgium), Katharine Sears (Sheffield, United Kingdom), Jessica G Shantha (San Francisco, USA), Amde Selassie Shifera (Rochester, USA), Marina Shneck (Beer Sheva, Israel), Shiri Shulman (Tel Aviv, Israel), Morela Silva (Caracas, Venezuela), Wantanee Sittivarakul (Songkhla, Thailand), Justine Smith (Adelaide, Australia), Lucia Sobrin (Boston, USA), Thanapong Somkijrungroj (Bangkok, Thailand), Ji Hun Song (Suwon, Republic of Korea/South Korea), Koh-Hei Sonoda (Fukuoka, Japan), Anka Stanojevic-Paovic (Belgrade, Serbia), Laura Steeples (Manchester, United Kingdom), Natacha Stolowy (Marseille, France), Nicole Stuebiger (Hamburg, Germany), Sridharan Sudharshan (Chennai, India), Ana Suelves (Columbus, USA), Masaki Takeuchi (Yokohama, Japan), Masaru Takeuchi (Tokorozawa, Japan), Christoph Tappeiner (Olten, Switzerland), Mei-Ling Tay-Kearney (Perth, Australia), Stephen C Teoh (Singapore, Singapore), Zheng Xian Thng (Singapore, Singapore), Jennifer E Thorne (Baltimore, USA), Yuan Tian (London, United Kingdom), Sara Touhami (Paris, France), Victoria Toumanidou (Larissa, Greece), Adelaide Toutee (Paris, France), Peter Trittibach (Biel, Switzerland), Ming-Ling Tsai (Taipei City, Taiwan), Edmund Tsui (Los Angeles, USA), Ilknur Tugal-Tutkun (Istanbul, Turkey), Mayjane J Tumulak (Cagayan de Oro, Philippines), Harvey S Uy (Manila City, Philippines), Julie Vadboncoeur (Montreal, Canada), Joachim Van Calster (Leuven, Belgium), Daniel V Vasconcelos-Santos (Belo Horizonte, Brazil), Erika Vazquez (Galdakao-Usansolo, Spain), Nataša Vidović Valentinčič (Ljubljana, Slovenia), Vicktoria Vishnevskia-Dai (Tel Aviv, Israel), François Willermain (Brussels, Belgium), Nilüfer Yalçındağ (Ankara, Turkey), Ryoji Yanai (Ube, Japan), Peizeng Yang (Chongqing, China), Nobuyo Yawata (Fukuoka, Japan), Stephanie Young (Sydney, Australia), Oren Yovel (Rehovot, Israel), Chao Yu-Jang (Taipei, Taiwan), Jekaterina Zaharova (Riga, Latvia), Mohammad Zarei (Tehran, Iran), Oleksandra Zborovska (Odesa, Ukraine).
Contributors JAB, BB, LBF, PJM, JET and JRS designed the questionnaire. JAB administered the questionnaire. JAB, JMM and JRS collated the questionnaire responses and drafted the manuscript. All authors reviewed and edited the draft. JRS is the guarantor.
Funding This work was supported by a National Health and Medical Research Council Investigator Grant (2025222, JRS).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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