References 1. Durrani et al. Br J Ophthalmol 2004;88:1159–1162 ; 2. Tomkins-Netzer et al. Ophthalmology 2014;121(12):2387-92. Title Durrani et al. 1 Moorfields Clinic Study 2 Period 1998-20002011-2013 Study Type Retrospective, non-interventional, observational survey Cross-sectional study Setting Tertiary referrral uveitis serviceUveitis clinic Location Birmingham & Midland Eye Centre, UKMoorfields Eye Hospital, London, UK # of Patients 3151076 Female gender (%) 61.6%56.6% Mean age at presentation 4840.7 Ethnic background 60,3% Caucasian; 27,9% Indian/Pakistani; 11,1% Afro-Caribbean; 0,6% mixed [no details] Mean duration of FU3 years5,6 years Less patients with vision loss or blindness in the Moorfields study compared to the Durrani study. Possible factors that contribute to this difference: Durrani tertiary referral centre: more patients likely to suffer from severe, often bilateral uveitis Higher mean age at presentation and slightly higher percentage of women in Durrani study Moorfields is a specialty centre, with better and faster access to maintenance treatment Time gap of 13 years between the studies: newer medications such as biologics and IMT available in Moorfields study Study Details MVL = moderate vision loss; SVL = severe vision loss Vision loss 31.7% of pts MVL 38.1% of pts SVL 8.8% of eyes permanent MVL 9.1% of eyes SVL Blindness 11.4% of pts (WHO criteria) 1.8% of pts legally blind Outcome
References 1. US Claims Database (2.3.13, Analysis 1); 2. Simon-Kucher & Partners Primary Research 2014, FR/GE/UK, payers n=12, KOLs n=13, physicians n=80; 3. Simon-Kucher & Partners Primary Research 2014, US, KOLs n=5, physicians n=112; 4. Nguyen et al. Ophthalmol 2011;118:184-190; 5. Tomkins-Netzer et al. Ophthalmology 2014;121(12):2387-92. Title TreatmentUS Claims 1 SKP 2,3 Nguyen et al. 4 (US) Moorfields 5 (% of eyes) Topical steroids16.2-3.2% (1-3 years)Topical and oral CS most prescribed treatments in first line therapy in EU and US Topical and oral CS most prescribed treatments Oral CS taken in high doses for a long time 74.3% Oral prednisolone12.8-2.4% (1-3 years)48.7% Local injection of CS16.3-3% (1-3 years)20.8% Ozurdex0.8-0.15% (1-3 years)1.3% Pts on oral prednisone requiring ≥1 second-line agent (IMT/biologics) 12% (3 years)Off-label use of biologics IMT: cyclosporin on label, others low or limited use 24.8% Ocular surgery9.7-2% (1-3 years)31.5% Differences in treatment rates found between studies Gnerally higher treatment rates in Moorfields clinic study may be due to it being a specialty centre with better access to newer medications, more off-label use, less restrictions in terms of pricing,… Results Moorfields study show that proper treatment and close follow-up reduce the progression of the disease 5 Proper treatmentClose follow-up Annual number of clinical visits: 6,3 High treatment rates Access to maintenance treatment & Positive effect on visual outcome parameters 8.8% of eyes permanent mild vision loss; 9.1% of eyes severe vision loss 1.8% of pts legally blind In Durrani staan geen treatment rates vermeld
References 1. x Title Opsiria offers treatment paradigm for first-line well-tolerated maintenance therapy Use of Opsiria Can be used first line Well tolerated maintenance therapy Mail GVS: gezien treatment rate niet representatief is zijn de data re. progression dit ook niet. de data bevestigen dus dat Opsiria treatment paradigm is: het kan wel in de normale setting gebruikt worden gezien label, niet de extreme prijzen van biologicals enz.