ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1041

Pharmaco-epidemiology of Non-infectious Ocular Inflammatory Disease in a Tertiary Academic Center

Sanjeev Patil1, Justine Cheng2, Lorraine Provencher3 and Scott Vogelgesang4, 1University of Vermont Medical Center, Essex Junction, VT, 2University of Iowa Hospitals and Clinics, Iowa City, IA, 3Cincinnati Eye Institute, Cincinnati, OH, 4University of Iowa Hospitals and Clinics, Iowa City, IA

Meeting: ACR Convergence 2020

Keywords: Disease-Modifying Antirheumatic Drugs (Dmards), Eye Disorders, Inflammation

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 8, 2020

Title: Miscellaneous Rheumatic & Inflammatory Diseases Poster II: Sarcoidosis, Interstitial Lung Disease, & Inflammatory Eye Disease

Session Type: Poster Session C

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

Background/Purpose: Non-Infectious Ocular inflammatory disease (OID) is a group of immune-mediated diseases involving the ocular surface, uveal tract, retina, optic nerve, and peri-orbital tissue. Patients are often referred to rheumatology for assistance with Disease-Modifying Anti-Rheumatic Drug (DMARD) therapy, when topical or systemic corticosteroids have not been completely effective. Real-world rheumatology practice of DMARD therapy selection to treat OID remains undescribed. We aim to describe the current DMARD prescribing practice at a tertiary academic center and identify effectiveness of these DMARDs.

Methods: Retrospective descriptive cohort study of patients with OID treated at an academic tertiary center from 2000 to 2017. Inclusion criteria: age > 18 years, use of DMARDs, ≥ 2 visits with a rheumatologist, treatment with oral corticosteroid (≥10mg). Exclusion criteria: DMARD use for a systemic autoimmune disease and not particularly for OID.

DMARD effectiveness was defined as disease control, as determined by the ophthalmologist, and the ability to taper oral prednisone to ≤ 10mg.  DMARD therapy was considered not effective when oral prednisone could not be tapered ≤10mg due to active disease, active ocular disease as evaluated by the ophthalmologist despite the DMARD, or the need to discontinue the DMARD due to adverse effects.

Proportions were used to describe demographic characteristics, diagnoses, DMARDs prescription trends and effectiveness.

Results: A total of 369 patients were identified and 162 met the inclusion criteria. Median age was 42 years [Interquartile Range (IQR) 29 – 56 years]. The majority were Caucasian (63.0%) and female (58.6%). The most common OID was uveitis (49.4%), followed by chorioretinopathy (18.5%), orbital inflammation (12.3%), scleritis (11.7%), keratitis (6.2%), and neuro-ophthalmic (1.9%) (Chart 1).

With the exception of chorioretinopathy, methotrexate was the most common initial DMARD used in all forms of OID, ranging from 29% in chorioretinopathy to 63.2% in orbital inflammation. Mycophenolate followed by adalimumab were the most common subsequent DMARDs chosen. Other anti-TNF biologics were not used as often.

Chart 2 shows effectiveness of DMARDs in the different forms of OID. Methotrexate was found to be more effective in uveitis (around 80%), scleritis and chorioretinopathy, as compared to in orbital inflammation and keratitis. Adalimumab was found to be highly effective in uveitis, orbital inflammation and scleritis.

Conclusion: Our data suggests that the most common OID rheumatologists at our center treat is Uveitis, while most common DMARD used is methotrexate. Methotrexate and adalimumab were more commonly noted to be effective in treating some forms of OID.

Some of the limitations of our study are that this is a single institutional study, with small cohort when broken down into various subgroups of OID diagnoses, many patients lost to follow up which led to their exclusion, and lack of standardized practice patterns and steroid tapering schedule.

While there are RCTs on treatment of anterior uveitis, there is a need for multicenter RCTs for difficult to treat anterior uveitis and other OIDs.


Disclosure: S. Patil, None; J. Cheng, None; L. Provencher, None; S. Vogelgesang, None.

To cite this abstract in AMA style:

Patil S, Cheng J, Provencher L, Vogelgesang S. Pharmaco-epidemiology of Non-infectious Ocular Inflammatory Disease in a Tertiary Academic Center [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/pharmaco-epidemiology-of-non-infectious-ocular-inflammatory-disease-in-a-tertiary-academic-center/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/pharmaco-epidemiology-of-non-infectious-ocular-inflammatory-disease-in-a-tertiary-academic-center/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology