Means of Collaboration between Ophthalmologists, Rheumatologists and Internists in the Management of Non-Infectious Uveitis: A Nationwide Study

Magali Pacanowski Fournier¹, Antoine Brezin², Christophe Chiquet Sr.³, David Saadoun⁴, Jeremie Sellam⁵, Patrice Cacoub⁶, Pascal Sève⁷, Bahram Bodaghi Sr.⁸ and Laurent Kodjikian Sr.^9,10,11, ¹medical department, Magali Pacanowski Fournier is employee of AbbVie and own AbbVie stock, Rungis, France, ²Ophtalmology, Referral Center for Rare Ophthalmological Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, ophtalmology, France, Paris, France, ³ophtalmology, CHU-Grenoble-Alpes, La Tronche, France, ⁴Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier, Paris, France, ⁵AP-HP Saint-Antoine hospital, Service de Rhumatologie, Inserm UMRS_938, Paris, France, ⁶Internal Medicine Department, University Hospital “Pitié-Salpêtrière”, “Pierre et Marie Curie Paris VI” University, Paris, France, Paris, France, ⁷Internal medicine, Internal medicine department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France, ⁸ophtalmology, Hôpital La Pitié-Salpêtrière; Université Sorbonne, paris, France, ⁹ophtalmology, Chu de La Croix-Rousse, hospices civils de Lyon, Lyon, France, ¹⁰université Claude Bernard lyon 1, villeurbanne, France, ¹¹UMR-CNRS 5510 Matéis, villeurbanne, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Biologic drugs, corticosteroids, management and uveitis

Session Information

Date: Tuesday, October 23, 2018

Title: Health Services Research Poster III – ACR/ARHP

Session Type: ACR/ARHP Combined Abstract Session

Session Time: 9:00AM-11:00AM

Background/Purpose:

When uveitis is believed to be part of an underlying systemic disease or when a systemic treatment is required, a multi-disciplinary approach is usually considered for the optimal management of the patients. The objective of this study was to evaluate the means of collaboration between ophthalmologists (OPHS), internal medicine specialists and rheumatologists (RHEUMS) in the care of patients with non-infectious uveitis.

Methods:

A multi-disciplinary (rheumatologist, internist, ophthalmologist) scientific committee built a common questionnaire to evaluate if and how French physicians collaborate in daily practice. Questionnaires were sent to all French ophthalmologists from 24^th November 2017 to 6^th March, 2018. Each OPH designed the Internist/Rheumatologist he usually works with. Questionnaires were also sent to all members of the CMIO (“club medicine interne et oeil”), a French group of internists and ophthalmologists involved in the management of uveitis patients.

All mandatory regulatory authorizations were obtained.

Results:

A total of 88 physicians completed the questionnaires (37 OPHS, 31 internists, 20 RHEUMS). The physicians’ means age was 44 ± 3 years, 53% were males and 84% was hospital-based (68% in university-hospitals, 30% in general hospitals). Among ophthalmology departments 51% had five or more full-time specialists and 45% showed more than 25 uveitis patients per month in their clinic. OPHS collaborated closely with internal medicine specialists in the management of uveitis patients, but not with RHEUMS. This collaboration took place in the same hospital in 83% of cases, but in a shared setting only in 9%. The means of collaboration were as follows: immediately consecutive appointments (7%), face-to-face meetings (23%), or letters (43%). Diagnostic was mainly done by OPHS alone for B27 positive uveitis or by internists for sarcoidosis. OPHS prescribed and managed the follow-up of corticosteroid treatment, but not of corticosteroid-sparing therapies (immunosuppressant). Answers to the questionnaires were globally consistent between OPHS, internists and RHEUMS

Conclusion:

The management of patients with uveitis was mostly organized as collaboration between internal medicine specialists and OPHS, rather than with RHEUMS. Heterogeneous patterns of care were observed. This study may help to define goals to optimize a shared multidisciplinary approach for the management of patients with uveitis.

Disclosure: M. Pacanowski Fournier, AbbVie Inc., 1, 3; A. Brezin, None; C. Chiquet Sr., AbbVie Inc., 5; D. Saadoun, Medimmune, Abbvie, Bristol Meyer Squibb, Roche, Servier, Gilead, AstraZeneca and Glaxo Smith Kline, 5; J. Sellam, None; P. Cacoub, Abbvie, Astra Zeneca, Bristol-Myers Squibb, Gilead, Glaxo Smith Kline, Janssen, Merck Sharp Dohme, Roche, Servier and Vifor, 5; P. Sève, Novartis, 5,AbbVie Inc., 5,LFB, 8,Pfizer, Inc., 8,SOBI, 8,AbbVie Inc., 8; B. Bodaghi Sr., allergan, 5,AbbVie Inc., 5,Santen, 5,Optos, 5; L. Kodjikian Sr., AbbVie Inc., 5,allergan, 5,Bayer, 5,Novartis, 5,Krys, 5,Roche, 5,Horus, 5,thea, 5.

To cite this abstract in AMA style:

Pacanowski Fournier M, Brezin A, Chiquet C Sr., Saadoun D, Sellam J, Cacoub P, Sève P, Bodaghi B Sr., Kodjikian L Sr.. Means of Collaboration between Ophthalmologists, Rheumatologists and Internists in the Management of Non-Infectious Uveitis: A Nationwide Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/means-of-collaboration-between-ophthalmologists-rheumatologists-and-internists-in-the-management-of-non-infectious-uveitis-a-nationwide-study/. Accessed .

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