Produção Nacional
Revisado por pares
Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis
2018; Elsevier BV; Volume: 125; Issue: 5 Linguagem: Inglês
10.1016/j.ophtha.2017.11.017
ISSN1549-4713
AutoresAndrew D. Dick, James T. Rosenbaum, Hassan Al-Dhibi, Rubens Belfort, Antoine P. Brézin, Soon‐Phaik Chee, Janet L. Davis, Athimalaipet V Ramanan, Koh‐Hei Sonoda, Ester Carreño, Heloísa Nascimento, S. Ben Salah, Sherveen Salek, Jay Siak, Laura R Steeples, Massimo Accorinti, Nisha R. Acharya, Alfredo Adán, Rupesh Agrawal, Nurullah Akkoç, Saed Al Ghamdi, Turki Al Ghamdi, Anood Al Saati, Nasser Alsabaani, Mohamed Al-Shamarani, Artur Bachta, Talin Barisani‐Asenbauer, Nicholas A. V. Beare, Fernanda Belga Ottoni Porto, Ricardo Blanco, Anita Chan Sook Yee, Vinod Chandran, Christophe Chiquet, Hiok Hee Chng, Andrius Cimbalas, Luca Cimino, Miguel Cordero‐Coma, C. Blanco Cristóbal, Miguel Cuevas, João Eurico da Fonseca, Joke de Boer, Alejandra de‐la‐Torre, Ilse De Schryver, Larissa Derzko-Dzulynsky, David Díaz‐Valle, Claudia Eugenia Duran Merino, Andrea Facskó, Luís Figueira, Alejandro Fonollosa, Éric Fortin, Richard Gale, Mauro Galeazzi, Sandra García, José María García Ruiz de Morales, Nataša Gašperšič, Debra A. Goldstein, Marta Guedes, Yan Guex‐Crosier, Ahmet Gül, Rola N. Hamam, Muhammad Haroon, Kenichi Hasegawa, Arnd Heiligenhaus, Claire Hooper, Yih‐Shiou Hwang, De‐Kuang Hwang, Xavier Juanola, Toshikatsu Kaburaki, Sibel Kadayıfçılar, John H. Kempen, Takeshi Kezuka, Amin Kherani, Maarja Kirsimäe, Kaisu Kotaniemi, Aleksandra Kraut, Agnieszka Kubicka‐Trząska, Lucia Kuffová, Susan Lightman, Lyndell L. Lim, Wee Kiak Lim, Peter McCluskey, Mairide McGuire, Pierfrancesco Mirabelli, Elisabetta Miserocchi, Marta Misiuk‐Hojło, Cristina Muccioli, Santiago León Atehortúa Muñoz, Conor C. Murphy, Philip I. Murray, Zoltán Zsolt Nagy, Kenichi Namba, Piergiorgio Neri, Quan Dong Nguyen, Donncha O’Gradaigh, Mohammed A. Omair, Kati Otsa, Yılmaz Özyazgan, Franco Pablo, Maria Pia Paroli, Uwe Pleyer, Gyula Poór, Rui Proença, Theodore Rabinovitch, Russell W. Read, Margarita Rebrov, Claudia Recillas-Gispert, Aniki Rothová, Sergio Schwartzman, P. Sève, Srilakshmi M. Sharma, Joanne L Sims, Nicolette Sohár, Eric B. Suhler, Sándor Szántó, Zsuzsanna Szepessy, Christoph Tappeiner, Jennifer E. Thorne, İlknur Tuğal Tutkun, Anna Turno‐Kręcicka, Joachim Van Calster, Irene van der Horst‐Bruinsma, Nataša Vidović Valentinčič, Albert T. Vitale, Stephanie Voorduin Ramos, Nenad Vukojević, Denis Wakefield, François Willermain, F. Nilüfer Yalçındağ, Joyce Hisae Yamamoto, Stephen Yeh, Reda Žemaitienė, Olga Ziouzina,
Tópico(s)Systemic Lupus Erythematosus Research
ResumoAn international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics.The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents.An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence.In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed.Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents.
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