Retrospective Medical Record Review to Describe Use of Repository Corticotropin Injection Among Patients with Uveitis in the United States
Retrospective Medical Record Review to Describe Use of Repository Corticotropin Injection Among Patients with Uveitis in the United States
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DOI：
10.1089/jop.2018.0090
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发表时间：
2019-04-01
影响因子：
2.3
通讯作者：
Carroll, Susan
中科院分区：
文献类型：
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作者：
Nelson, Winnie W.;Lima, Antonio Flavio;Carroll, Susan
简介：Repository促肾上腺皮质激素注射液（RCI）具有免疫调节和抗炎作用，并被批准用于多种适应症，包括涉及眼睛和附件的严重和急性慢性过敏和炎症过程。这项研究描述了患者的特点，治疗模式，和医生的评估与葡萄膜炎患者接受RCI治疗。方法：这是对美国患者的回顾性病历审查。符合条件的患者被诊断为葡萄膜炎，在过去12个月内接受了RCI，并且在数据收集时已经完成或正在接受RCI治疗。基线特征和治疗后的临床数据进行了连续报告。结果：该研究包括91例患者（平均年龄41岁，62%为女性，自诊断以来的平均时间为3.98年）。大多数患者有中度（n = 48，53%）至重度（n = 21，23%）视力损害，在RCI治疗前无盲。患者在RCI前平均使用2.5种药物。每例患者的初始RCI给药方案、剂量调整和治疗持续时间不同。RCI期间减少了伴随药物的使用和剂量; 76例患者（84%）改善，15例患者（16%）保持不变，无患者恶化; 86%的患者视力改善。结论：医生对患有葡萄膜炎数年的患者进行个体化RCI治疗，并且以前的治疗不充分。大多数患者在开始RCI后有所改善，最常见的是视力。研究结果支持使用RCI治疗葡萄膜炎，并提供了对患者特征和实践模式的更好理解，以指导适当的使用。
Introduction: Repository corticotropin injection (RCI) has immune-modulatory and anti-inflammatory effects and is approved for multiple indications, including severe and acute chronic allergic and inflammatory processes involving the eye and adnexa. This study describes patient characteristics, treatment patterns, and physicians' assessments of patients with uveitis treated with RCI. Methods: This was a retrospective medical record review of US patients. Eligible patients had a diagnosis of uveitis, received RCI in the past 12 months, and had completed or were receiving RCI treatment at the time of data collection. Baseline characteristics and after-treatment clinical data are descriptively reported. Results: The study included 91 patients (mean age 41 years, 62% female, and mean time since diagnosis 3.98 years). Most patients had moderate (n = 48, 53%) to severe (n = 21, 23%) visual impairment, and none was blind before RCI therapy. Patients used an average of 2.5 medications before RCI. Initial RCI dosing regimens, dose adjustments, and treatment durations were different for each patient. Concomitant medication use and dosages were reduced during RCI; 76 patients (84%) improved, 15 patients (16%) stayed the same, and none worsened; 86% of patients had improvements in vision. Conclusions: Physicians individualized RCI therapy among patients who suffered uveitis for several years and when previous therapies were inadequate. Most patients improved after initiating RCI, most commonly in vision. The findings support use of RCI for uveitis and provide a better understanding of patient characteristics and practice patterns to guide appropriate use.