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Dolinko AH, Morvey DE, Apoorva S, Chikovsky M, Anesi SD, Foster CS. Effects of non-medical infliximab biosimilar switching in ocular inflammatory diseases: A case series from a tertiary care center. Eur J Ophthalmol 2024; 34:774-780. [PMID: 37671431 DOI: 10.1177/11206721231199778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
PURPOSE To describe the course of care and outcomes for 3 uveitis patients formerly on Remicade that were non-medically switched to Inflectra. DESIGN Retrospective observational case series. METHODS •Setting: Tertiary care clinical practice.•Patient population: 3 Uveitis patients, observing both eyes for inflammation as applicable. Patients included if they had been on Inflectra for ≥2 infusions and history of Remicade use. Patients described herein had at least 1 adverse reaction to Inflectra and were switched to Remicade for medical necessity. Patients excluded if they were lost to follow-up or not examined for over 6 months during therapy.•Observation procedures/Interventions: Patients observed for adverse changes in clinical course while on Inflectra. Patients developing these changes on Inflectra were started or restarted on Remicade. RESULTS The 3 patients described herein developed adverse complications while on Inflectra that required switching to Remicade. They were originally on Remicade, and their clinical course worsened beyond what had been controlled with Remicade alone. Our findings are limited by our small sample size, and further investigation is necessary to explore the scope of effects of non-medical biosimilar switching. CONCLUSION Non-medical biosimilar switching from Remicade to Inflectra may induce detrimental side-effects and significant worsening of inflammation in patients with uveitis. Non-medical biosimilar switching from Remicade to Inflectra should be discouraged, and physician input should be sought in establishing an effective and medically-necessary treatment plan for patients with uveitis.
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Affiliation(s)
- Andrew H Dolinko
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
| | - Diana Edem Morvey
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
| | - Shimy Apoorva
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
| | - Max Chikovsky
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
| | - Stephen D Anesi
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
| | - C Stephen Foster
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
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2
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Yılmaz Tuğan B, Sarıhan M, Kasap M, Akpınar G, Karabaş L, Şahin N, Yüksel N, Bayrak YE, Sönmez HE. Is tear proteome profile a predictor of developing uveitis in ANA-positive patients with oligoarticular juvenile idiopathic arthritis? Graefes Arch Clin Exp Ophthalmol 2024; 262:211-221. [PMID: 37773290 DOI: 10.1007/s00417-023-06251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023] Open
Abstract
PURPOSE Although less than one-third of anti-nuclear antibody (ANA) positive patients with oJIA develop uveitis, ANA positivity is still the most well-known marker for assessing the risk of uveitis in oligoarticular JIA (oJIA). Therefore, novel biomarkers are needed to better assess the risk of developing uveitis. For this purpose, we performed a comparative tear proteome analysis of uveitis patients to reveal the identity of differentially regulated proteins. DESIGN Tear samples were collected using the Schirmer strips in 7 oJIA and 7 oJIA patients with uveitis (oJIA-U). All oJIA-U patients had developed bilateral anterior uveitis and were inactive and topical treatment-free. METHODS The nHPLC LC-MS/MS system was used for protein identification and label-free proteome comparisons. The PANTHER and STRING analyses were carried out using UniProt accession numbers of the identified proteins. RESULTS Patient characteristics, e.g., age, gender, disease duration, and treatments were similar. For protein identification, three different databases were searched. Twenty-two, 147, and 258 database searches, respectively. Of these, 15 were common to all three proteome databases. Of these 15 proteins, 10 proteins were upregulated, and 2 were downregulated, based on the twofold regulation criteria. The upregulated proteins were, namely, cystatin-S, secretoglobin family 1D member, opiorphin prepropeptide, mammaglobin-B, lysozyme C, mesothelin, immunoglobulin kappa constant, extracellular glycoprotein lacritin, beta-2-microglobulin, and immunoglobulin J chain. The downregulated proteins were dermcidin and prolactin-inducible protein. Among the differentially regulated proteins, cystatin-S was the most regulated protein with an 18-fold upregulation ratio in tear samples from uveitis patients. CONCLUSION Here, the identities and regulation ratios of several proteins were revealed when tear samples from uveitis patients were compared to patients without uveitis. These proteins are putative biomarkers for assessing uveitis risk and require further attention.
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Affiliation(s)
- Büşra Yılmaz Tuğan
- Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
| | - Mehmet Sarıhan
- Department of Basic Medical Sciences, Medical Biology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Murat Kasap
- Department of Basic Medical Sciences, Medical Biology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Gürler Akpınar
- Department of Basic Medical Sciences, Medical Biology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Levent Karabaş
- Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Nihal Şahin
- Department of Pediatrics, Division of Pediatric Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Nurşen Yüksel
- Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Yunus Emre Bayrak
- Department of Pediatrics, Division of Pediatric Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatrics, Division of Pediatric Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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Fukuda Y, Yawata N, Hasegawa E, Yamana S, Shirane M, Ito T, Takeda A, Sonoda M, Eguchi K, Ishimura M, Ohga S, Sonoda KH. Clinical Features of Pediatric Uveitis at a Tertiary Referral Center in the Western Region of Japan. Ocul Immunol Inflamm 2023; 31:2032-2038. [PMID: 37917805 DOI: 10.1080/09273948.2023.2273363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This study aimed to assess the clinical features of pediatric uveitis at a tertiary referral center in Western Japan. METHODS One hundred forty eyes of 80 patients aged <20 years at the time of uveitis onset, who visited Kyushu University Hospital between January 2010 and December 2019 were included in this study. Clinical records were retrospectively reviewed. Demographics, clinical findings, treatments, and visual prognoses were compared between the disease groups. RESULTS Of 80 patients, 32 were males and 48 were females. The average age of onset was 12.5 ± 4.8 (0-19) years. Tubulointerstitial nephritis and uveitis (TINU) and juvenile idiopathic arthritis (JIA) were the most frequent causes, accounting for 11.3% and 10% of cases, respectively, followed by sarcoidosis (5%), Behçet's disease, acute anterior uveitis, Vogt-Koyanagi-Harada disease, and juvenile chronic iridocyclitis (3.8% each). Infectious uveitis accounted for 7.6% of the cases: cytomegalovirus was the most frequent agent. Of these cases, 43.8% were unclassified. Systemic therapies were administered to 87.5% of the patients with JIA, 33.3% of those with TINU, and 28.6% of the other diagnostic groups. In the unclassified group, 80% of the patients were followed up with only topical corticosteroids. LogMAR visual acuity of 0 or less accounted for more than 80% in the final examination. CONCLUSION TINU and JIA were the most common causes of pediatric uveitis. Although each required systemic therapy, most unclassified cases of pediatric uveitis were managed by topical corticosteroids alone with good visual prognosis. Accurate diagnosis is important for pediatric uveitis management.
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Affiliation(s)
- Yosuke Fukuda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyo Yawata
- Department of Ocular Pathology and Imaging Science, Kyushu University, Fukuoka, Japan
- Ocular Inflammation and Immunology, Singapore Eye Research Institute, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Eiichi Hasegawa
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Yamana
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Mariko Shirane
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takako Ito
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Atsunobu Takeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoshi Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuhide Eguchi
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masataka Ishimura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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van Meerwijk CLLI, Wieringa WG, de Boer JH, Jansonius NM, Los LI. Factors Associated With Glaucoma Surgery in Pediatric Non-Infectious Uveitis. Ocul Immunol Inflamm 2023; 31:2018-2023. [PMID: 36731522 DOI: 10.1080/09273948.2023.2166849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE To identify factors associated with glaucoma surgery in pediatric uveitis. METHODS Patients diagnosed with uveitis before their 18th birthday and with an observation period of at least one year were included in a retrospective case-control study. RESULTS A total of 185 patients were included, 84 of whom had undergone glaucoma surgery. Juvenile idiopathic arthritis (JIA)-related uveitis was associated with undergoing glaucoma surgery (p = .002). In the JIA-subgroup, the presence of anterior segment complications (OR 3.1 (95% CI 1.0 to 9.6); P = .045) and an IOP > 21 mmHg during the first uveitis remission (OR 4.5 (95% CI 1.3 to 15.2); P = .015) were associated with an increased risk of glaucoma surgery. Sixty-eight percent of the cases needed glaucoma surgery within one year after they started IOP-lowering triple therapy. CONCLUSION The risk profile for undergoing glaucoma surgery as outlined in this study is a valuable help to recognize and treat secondary glaucoma in a timely manner.
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Affiliation(s)
- Charlotte L L I van Meerwijk
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | - Wietse G Wieringa
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joke H de Boer
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands
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5
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Narayan AR, Rahi JS, Solebo AL. Temporal Trends in Childhood Uveitis: Using Administrative Health Data to Investigate the Impact of Health Policy and Clinical Practice. Ocul Immunol Inflamm 2022; 30:1931-1935. [PMID: 34648413 PMCID: PMC11166048 DOI: 10.1080/09273948.2021.1976215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/30/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND We describe an investigation of temporal trends in the incidence of childhood uveitis-related hospital admissions, hospitalization being a robust indicator of disease severity. METHODS A population-based retrospective study using a hospitalization database, the Hospital Episode Statistics (HES) dataset, capturing data on care between 2013 and 2020. Primary outcomes were rates of pediatric hospital admissions for uveitis-related disorders. RESULTS During the study period, there were 3,258 reported uveitis-related hospital admissions of children aged 0 to 14 years, comprising 19% of all-age uveitis-related admissions. Anterior uveitis was the most common diagnosis. The annual incidence of childhood uveitis-related hospitalizations declined year on year from a peak incidence of 5.4 per 100,000 children (95% confidence interval 5.0-5.9) in 2015-2016 to 3.3 per 100,000 (95% CI 3.0-3.6) in 2019-2020. Over the same period, the national incidence of juvenile arthropathy-related admissions stayed stable. CONCLUSION The decline in admissions nationally may reflect reduced incidence of uveitis complications with increasing use of immunosuppressive therapies.
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Affiliation(s)
- Akshay R. Narayan
- UCL Institute of Ophthalmology, University College London, London, UK
| | - Jugnoo S. Rahi
- Population, Policy and Practice Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK
- National Institute for Health Research Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
- Ophthalmology and Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
- Ulverscroft Vision Research Group, Institute of Child Health, University College London, London, UK
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Ameenat Lola Solebo
- Population, Policy and Practice Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK
- National Institute for Health Research Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
- Ophthalmology and Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
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6
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Molimard J, Pajot C, Olle P, Belot A, Quartier P, Uettwiller F, Couret C, Coste V, Costet C, Bodaghi B, Dureau P, Bailhache M, Pillet P. Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice. Pediatr Rheumatol Online J 2021; 19:139. [PMID: 34479590 PMCID: PMC8414774 DOI: 10.1186/s12969-021-00626-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surgeries for idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children are complex because of the high risk of inflammatory postoperative complications. There is no consensus about treatment adaptation during the perioperative period. The objectives of this study are to report the therapeutic changes made in France and to determine whether maintaining or stopping immunosuppressive therapies is associated with an increased risk of surgical site infection or an increased risk of uveitis or arthritis flare-up. METHODS We conducted a retrospective cohort study between January 1, 2006 and December 31, 2018 in six large University Hospitals in France. Inclusion criteria were chronic idiopathic uveitis or chronic uveitis associated with juvenile idiopathic arthritis under immunosuppressive therapies at the time of the surgical procedure, operated before the age of 16. Data on perioperative treatments, inflammatory relapses and post-operative infections were collected. RESULTS A total of 76 surgeries (42% cataract surgeries, 30% glaucoma surgeries and 16% posterior capsule opacification surgeries) were performed on 37 children. Adaptation protocols were different in the six hospitals. Immunosuppressive therapies were discontinued in five cases (7%) before surgery. All the children in the discontinuation group had an inflammatory relapse within 3 months after surgery compared to only 25% in the other group. There were no postoperative infections. CONCLUSIONS The results of this study show varying practices between centres. The benefit-risk balance seems to favour maintaining immunosuppressive therapies during surgery. Further studies are needed to determine the optimal perioperative treatments required to limit post-operative inflammatory relapses.
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Affiliation(s)
- Julie Molimard
- Pediatric diseases and Rheumatology, CHU Bordeaux, Bordeaux, France.
| | - Christine Pajot
- grid.411175.70000 0001 1457 2980Department of Pediatric Nephrology, Internal Medicine and Hypertension, CHU Toulouse, Toulouse, France
| | - Priscille Olle
- grid.414282.90000 0004 0639 4960Department of Ophtalmology, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - Alexandre Belot
- grid.413852.90000 0001 2163 3825Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Femme Mère Enfant, CHU Lyon, Lyon, France
| | - Pierre Quartier
- grid.412134.10000 0004 0593 9113Paediatric Hematology-Immunology and Rheumatology Department, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Florence Uettwiller
- grid.411167.40000 0004 1765 1600Department of Allergology and Clinical Immunology, Hôpital Clocheville, CHRU de Tours, Tours, France
| | - Chloé Couret
- grid.277151.70000 0004 0472 0371Department of Ophtalmology, Hôtel-Dieu, CHU Nantes, Nantes, France
| | - Valentine Coste
- grid.42399.350000 0004 0593 7118Department of Ophtalmology, CHU Bordeaux, Bordeaux, France
| | - Camille Costet
- grid.42399.350000 0004 0593 7118Department of Ophtalmology, CHU Bordeaux, Bordeaux, France
| | - Bahram Bodaghi
- grid.411439.a0000 0001 2150 9058Department of Ophtalmology, Hopital Pitié-Salpêtrière, APHP, Paris, France
| | - Pascal Dureau
- grid.417888.a0000 0001 2177 525XPediatric Ophthalmology Department, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Marion Bailhache
- grid.42399.350000 0004 0593 7118Department of Pediatric emergencies, CHU Bordeaux, Bordeaux, France
| | - Pascal Pillet
- grid.42399.350000 0004 0593 7118Pediatric diseases and Rheumatology, CHU Bordeaux, Bordeaux, France
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7
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Matsuo T, Yashiro M. Long-Term Control of Macular Edema With Adalimumab After Cataract Surgery in a Japanese Child With Juvenile Idiopathic Arthritis: Case Report and Review of 26 Japanese Patients. J Investig Med High Impact Case Rep 2021; 8:2324709620953283. [PMID: 32862718 PMCID: PMC7457411 DOI: 10.1177/2324709620953283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Juvenile idiopathic arthritis–associated uveitis is rare in the Japanese
population. In this article, we report a child whose macular edema was
controlled for years after cataract surgery with adalimumab, and reviewed 26
Japanese patients in the literature. In this case report, a 4-year-old boy
developed band keratopathy, posterior iris synechiae, and complicated cataract
in both eyes. Oral prednisolone prescribed at another hospital was discontinued
due to high intraocular pressure in both eyes as a steroid responder. At the age
of 5 years, he started oral methotrexate 8 mg weekly for recurrent bilateral
iridocyclitis and then underwent lensectomy with core vitrectomy in both eyes.
Planned intraocular lens implantation was cancelled at surgery because the
anterior vitreous had severe inflammatory opacity with diffuse retinal edema in
both eyes. Due to persistent macular edema in both eyes 5 months
postoperatively, at the age of 6 years, he began to use adalimumab injection 20
mg every 2 weeks. The macular structure depicted by optical coherence tomography
became normal in 2 months. At final visit at the age of 11 years, he had the
best-corrected visual acuity of 0.8 in the right eye and 0.4 in the left eye,
with adalimumab 40 mg every 2 weeks and methotrexate 8 mg weekly. In conclusion,
macular edema persistent despite oral methotrexate after cataract surgery could
be controlled for long term by adalimumab in a child with juvenile idiopathic
arthritis. In the Japanese literature, only 26 additional cases with juvenile
idiopathic arthritis–associated uveitis have been reported so far.
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Affiliation(s)
- Toshihiko Matsuo
- Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama City, Japan.,Ophthalmology, Okayama University Hospital and Okayama University Medical School, Okayama City, Japan
| | - Masato Yashiro
- Pediatrics, Okayama University Hospital and Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Japan
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8
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Chen JL, Abiri P, Tsui E. Recent advances in the treatment of juvenile idiopathic arthritis-associated uveitis. Ther Adv Ophthalmol 2021; 13:2515841420984572. [PMID: 33681703 PMCID: PMC7897841 DOI: 10.1177/2515841420984572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
Abstract
Juvenile idiopathic arthritis-associated uveitis has an estimated prevalence of 10-20% in patients with juvenile idiopathic arthritis, making it the most common cause of chronic anterior uveitis in children. Prompt treatment is important to prevent development of ocular complications and permanent vision loss. In this review, we will discuss the use of immunosuppression in treatment of juvenile idiopathic arthritis-associated uveitis. This will include the use of conventional immunosuppressants, such as methotrexate, biologic anti-tumor necrosis factor agents, such as adalimumab, as well as other anti-tumor necrosis factor agents, including infliximab and golimumab. In addition, we will discuss medications currently in clinical trials or under consideration for juvenile idiopathic arthritis-associated uveitis, including interleukin-6 inhibitors (tocilizumab) and Janus kinase inhibitors (tofacitinib, baricitinib).
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Affiliation(s)
- Judy L Chen
- Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Parinaz Abiri
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Edmund Tsui
- Assistant Professor of Ophthalmology, Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 200 Stein Plaza, Los Angeles, CA 90095-7003, USA
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9
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Petty RE, Zheng Q. Uveitis in juvenile idiopathic arthritis. World J Pediatr 2020; 16:562-565. [PMID: 31965444 DOI: 10.1007/s12519-019-00331-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Ross E Petty
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Qi Zheng
- Department of Rheumatology Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, 57# Zhu Gan Road Zhejiang Province, Hangzhou, 310000, China
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10
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Abdul Razak S, Makmor Bakry M, Mohamed Said MS, Tan CE, Md Redzuan A. Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs. Front Pharmacol 2020; 11:572260. [PMID: 33240088 PMCID: PMC7681069 DOI: 10.3389/fphar.2020.572260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/29/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence level in patients using subcutaneous injections of bDMARDs utilized the indirect methods adapted from adherence assessment for oral medication. Aim: This study aimed to develop a questionnaire to assess adherence to the self-injectable subcutaneous bDMARDs. Methods: The development of the Subcutaneous bDMARDs Adherence Score (SCADS) involved evaluation of content validity. Literature reviews provide the basis for domain identification and item formation. Four experts evaluated the instrument by using a four-point ordinal scale with a rubric scoring on relevance, importance, and clarity of each item in measuring the overarching construct. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI) were calculated. The factor structure and internal consistency reliability of SCADS were estimated using principal component analysis (PCA) and Cronbach's alpha, respectively. Results: Both S-CVI/UA (universal agreement) and the average item-level content validity index (S-CVI/Ave) (average) for the entire instrument showed excellent criteria with a value of >0.90. Cronbach's alpha coefficient value for SCADS was 0.707 indicating good internal consistency. All items showed corrected item-total correlation coefficients above 0.244. Questionnaire items with a factor loading of 0.30 or above were considered in the final factor solution. The factor analysis resulted in 3-factor solutions, which corresponded to 66.62% of the total variance. Conclusion: The SCADS is a consistent and reliable instrument for evaluating adherence among IA patients using the subcutaneous bDMARDs. It is simple to use, yet comprehensive but still requiring further clinical and international validation.
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Affiliation(s)
- Salmi Abdul Razak
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - Mohd Makmor Bakry
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Chai-Eng Tan
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adyani Md Redzuan
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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11
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Ackerman IM, Goldberg NR, Kodsi SR. Initial Occurrence of Bilateral Anterior Uveitis in a Patient with Juvenile Idiopathic Arthritis following Discontinuation of Topical Steroids after Bilateral Strabismus Surgery. Ocul Immunol Inflamm 2020; 30:628-629. [PMID: 33054478 DOI: 10.1080/09273948.2020.1826538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Post-operative inflammation is a well-known complication of intraocular surgery. This is especially true in patients with a prior history of uveitis or with a predisposition for an inflammatory response. We report the first published case of a patient who developed bilateral anterior uveitis after bilateral strabismus surgery. It was the first episode of uveitis for this patient who had a pre-existing diagnosis of juvenile idiopathic arthritis.
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Affiliation(s)
- Israel M Ackerman
- Department of Ophthalmology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA
| | - Naomi R Goldberg
- Department of Ophthalmology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA
| | - Sylvia R Kodsi
- Department of Ophthalmology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA
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12
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Castagna I, Roszkowska AM, Alessandrello F, Oliverio GW, Tumminello G, Gallizzi R, Conti G, Aragona P. Juvenile idiopathic arthritis-associated uveitis: a retrospective analysis from a centre of South Italy. Int Ophthalmol 2019; 40:335-342. [PMID: 31586268 DOI: 10.1007/s10792-019-01184-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To investigate the clinical and laboratory characteristics of the children affected by juvenile idiopathic arthritis (JIA) who developed uveitis. METHODS In this retrospective study, we have examined data of 109 patients aged from 3 to 16 years, affected by JIA and followed at Paediatrics Rheumatology Clinic and Ophthalmology Clinic of University Hospital of Messina in the period from 2007 to 2017. The main outcome measures were clinical and laboratory findings related to JIA and ocular involvement. The prevalence of ocular signs and symptoms was determined and correlated with age. RESULTS Twenty-one (19.3%) subjects developed uveitis. Two different peaks of age with ocular involvement were registered. The first occurred between 4 and 6 years and the second between 10 and 12 years. All subjects in the first group resulted to be female, presented oligoarticular arthritis and chronic anterior uveitis. In the second group, the 84% of patients were male with different types of JIA and acute anterior uveitis. The prevalence of ocular complications was higher in the first group. CONCLUSIONS Two peaks of age emerged and were characterized by different clinical outcomes of arthritis and ocular involvement. The first occurred between 4 and 6 years and interested females affected by oligoarticular JIA who develop chronic anterior uveitis. The second appeared at 10-12 years and interested older males affected by different types of JIA with acute anterior uveitis. Early diagnosis and cooperation between paediatric rheumatologist and ophthalmologist are of great importance in the proper management of JIA children with uveitis.
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Affiliation(s)
- I Castagna
- Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy
| | - A M Roszkowska
- Ophthalmology Section, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland. .,A.O.U. Policlinico G. Martino Messina, Via Consolare Valeria 1, 98125, Messina, Italy.
| | - F Alessandrello
- Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy
| | - G W Oliverio
- Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy
| | - G Tumminello
- Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy
| | - R Gallizzi
- Unit of Pediatrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - G Conti
- Pediatric Nephrology and Rheumatology Unit, University Hospital of Messina, Messina, Italy
| | - P Aragona
- Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy
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13
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Mauro A, Rigante D, Cimaz R. Investigational drugs for treatment of juvenile idiopathic arthritis. Expert Opin Investig Drugs 2017; 26:381-387. [PMID: 28277884 DOI: 10.1080/13543784.2017.1301929] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Angela Mauro
- Department of Pediatrics, San Giacomo Hospital, Novi Ligure, Italy
| | - Donato Rigante
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Rolando Cimaz
- Rheumatology Unit, Anna Meyer Children’s Hospital, University of Florence, Florence, Italy
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14
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Cunningham ET, Smith JR, Tugal-Tutkun I, Rothova A, Zierhut M. Uveitis in Children and Adolescents. Ocul Immunol Inflamm 2017; 24:365-71. [PMID: 27471956 DOI: 10.1080/09273948.2016.1204777] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Emmett T Cunningham
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA.,b The Department of Ophthalmology , Stanford University School of Medicine , Stanford , California , USA.,c The Francis I. Proctor Foundation , UCSF School of Medicine , San Francisco , California , USA
| | - Justine R Smith
- d Eye & Vision Health , Flinders University School of Medicine , Adelaide , South Australia , Australia
| | - Ilknur Tugal-Tutkun
- e Department of Ophthalmology , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Aniki Rothova
- f Department of Ophthalmology ; Erasmus Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Manfred Zierhut
- g Centre for Ophthalmology , University Tuebingen , Tuebingen , Germany
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