Imaging plays a key role in the diagnosis, treatment and prognosis of uveitis. As uveitis case can be challenging especially the refractory ones the use of imaging is critical. Therefore on the ...already Gold standard Techniques (FFA / ICGA/OCT) new imaging modalities (wide filed imaging /FAF/ EDI/OCT‐A) are offering a better appreciation of the pathophysiologic mechanism involved, provide also non‐invasive methods to accurately diagnose differentiate, monitor the response to treatment or even demonstrate Biomarkers for disease activity. Thus significantly contributes to better visual and functional outcomes on the uveitis group patients.
Teifi James will explain the crucial importance of the history in the clinical presentation of Uveitis. He will discuss key signs and how to confirm their presence or absence. Teifi will also explain ...how the urgency of the situation depends on the clinical presentation. He will then proceed to consider which laboratory tests are appropriate depending on clinical presentation. He will close by mentioning the different treatment options that are available for Uveitis.
To evaluate safety and efficacy of adalimumab in patients with noninfectious intermediate, posterior, or panuveitis.
Phase 3, open-label, multicenter clinical trial extension (VISUAL III).
Adults ...meeting treatment failure (TF) criteria or who completed VISUAL I or II (phase 3, randomized, double-masked, placebo-controlled) without TF.
Patients received adalimumab 40 mg every other week. Interim follow-up data were described from VISUAL III weeks 0 through 78.
Disease quiescence, steroid-free quiescence, active inflammatory chorioretinal/retinal vascular lesions, anterior chamber cell grade, vitreous haze grade, best-corrected visual acuity (BCVA), and corticosteroid dose. Binary data were reported using nonresponder imputation (NRI), continuous data using last observation carried forward and as-observed analysis, and corticosteroid dose using observed-case analysis. Adverse events (AEs) were reported from first adalimumab dose in VISUAL III through interim cutoff.
Of 424 patients enrolled, 371 were included in intent-to-treat analysis. At study entry, 242 of 371 (65%) patients had active uveitis; 60% (145/242, NRI) achieved quiescence at week 78, and 66% (95/143, as-observed) of those were corticosteroid free. At study entry, 129 of 371 (35%) patients had inactive uveitis; 74% (96/129, NRI) achieved quiescence at week 78, and 93% (89/96, as-observed) of those were corticosteroid free. Inflammatory lesions, anterior chamber grade, and vitreous haze grade showed initial improvement followed by decline in patients with active uveitis and remained stable in patients with inactive uveitis. BCVA improved in patients with active uveitis from weeks 0 to 78 (0.27 to 0.14 logMAR; left and right eyes; as-observed) and remained stable in patients with inactive uveitis. Mean corticosteroid dose decreased from 13.6 mg/day (week 0) to 2.6 mg/day (week 78) in patients with active uveitis and remained stable in those with inactive uveitis (1.5–1.2 mg/day). AEs (424 events/100 patient-years) and serious AEs (16.5 events/100 patient-years) were comparable with previous VISUAL trials.
Patients with active uveitis at study entry who received adalimumab therapy were likely to achieve quiescence, improve visual acuity, and reduce their daily uveitis-related systemic corticosteroid use. Most patients with inactive uveitis at study entry sustained quiescence without a systemic corticosteroid dose increase. No new safety signals were identified.
The presentation will focus in the relevant tests and investigations for the safe use of biologic therapy in non‐infectious uveitis. Biologic therapy when used appropriately in the treatment of ...non‐infectious uveitis is a very safe alternative, but some considerations are needed to take into account before starting treatment.
What are the options when anti‐TNK‐alpha therapy fails? What it is the evidence for these alternatives. The presentation will cover current evidence in non‐anti‐TNF‐alpha biologic therapy and new ...molecules with a potential role in the treatment of non‐infectious uveitis.
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