Publications by authors named "Miguel Cordero Coma"
The leading cause of blindness due to non-infectious uveitis is cystoid macular edema (CME). Behçet's disease (BD) is one of the most commonly conditions related to CME. To compare the effectiveness and safety of adalimumab (ADA), infliximab (IFX) and certolizumab (CZP) in refractory CME due to BD.
View Article and Find Full Text PDFBackground: Evaluating the efficacy and refractoriness to treatment and determining factors associated with adverse outcomes in uveitis associated with spondylarthritis (SpA) are complicated by the lack of validated outcome measures.
Objectives: The aims of this study were to develop an outcome score SpA-U in patients with uveitis associated with SpA and to determine factors associated with adverse outcomes in patients with uveitis under systemic treatment.
Methods: The outcome score SpA-U was defined by best-corrected visual acuity, anterior chamber inflammation, macular edema and inflammation of posterior chamber, global assessment, and refractoriness to treatment.
Introduction: Uveitis is the inflammation of the middle layer of the eye, the uvea, and is a major cause of blindness. None of the instruments used in clinical practice are, in themselves, sufficient to evaluate the course of uveitis. Therefore, it is necessary to develop instruments enabling standardized measurement of inflammatory activity.
View Article and Find Full Text PDFObjectives: To evaluate effectiveness and safety of certolizumab pegol (CZP) in uveitis due to immune-mediated inflammatory diseases (IMID).
Methods: Multicentre study of CZP-treated patients with IMID uveitis refractory to conventional immunosuppressant. Effectiveness was assessed through the following ocular parameters: best-corrected visual acuity, anterior chamber cells, vitritis, macular thickness and retinal vasculitis.
Article Synopsis
- The study aimed to compare the effectiveness of TNF inhibitors (adalimumab and infliximab) versus tocilizumab in treating refractory cystoid macular edema associated with Behçet’s disease.
- A multicenter analysis included 49 patients with cystoid macular edema who had already undergone other treatments; they were tracked for changes in macular thickness, visual acuity, and inflammation over four years.
- Results showed that all treatment options led to improvements in macular thickness and visual acuity, with tocilizumab still being effective for patients who did not respond to TNF inhibitors.
Purpose: To measure, characterize, and evaluate the clinical significance of anti-retinal antibodies in patients with sarcoid uveitis.
Subjects/methods: Prospective study of anti-retinal antibodies in 45 patients with biopsy-proven sarcoidosis (25 with and 20 without uveitis). Results were compared with patients with confirmed infectious uveitis (n = 40) and non-infectious uveitis (n = 40).
Article Synopsis
- Non-infectious uveitis is a complex condition that can be debilitating, often treated with immunosuppressive drugs, either alone or in combination, though the effectiveness of these strategies has not been directly compared.
- The CoTHEIA study is a significant research project designed to evaluate the safety, efficacy, and cost-effectiveness of methotrexate, adalimumab, and their combination in treating non-infectious non-anterior uveitis, involving 192 participants over a 52-week period.
- Ethical approvals are in place for the study, which will also employ machine learning to identify patient subgroups based on treatment response, and there are plans to widely disseminate the findings to various stakeholders.
Article Synopsis
- Anti-IL6R tocilizumab (TCZ) therapy shows promise for treating severe ocular and neurological symptoms in Behçet's disease (BD), but its effectiveness for other manifestations is uncertain.
- A study involved 16 patients, primarily with ocular and neurological issues, who were previously unresponsive to standard treatments, and they experienced significant improvement in their symptoms after TCZ therapy.
- While TCZ proved effective in addressing neurological and ocular domains, it was less successful for oral/genital ulcers and skin lesions, suggesting a selective efficacy depending on the specific manifestations of BD.
Objectives: Rapid control of intraocular inflammation in non-infectious uveitis (NIU) is mandatory to avoid irreversible structural and functional damage. In this study, we assessed the efficacy and safety of intravenous methylprednisolone (IVMP) pulses in the treatment of NIU.
Methods: A retrospective case series of 112 patients who received IVMP for the treatment of NIU, either isolated or associated with different underlying diseases, was studied.
Efficacy and safety of certolizumab pegol in pregnant women with uveitis. Recommendations on the management with immunosuppressive and biologic therapies in uveitis during pregnancy.
Clin Exp Rheumatol
February 2021
Objectives: Clinicians often face the challenge of providing effective and safe therapy for pregnant women with uveitis. Certolizumab pegol (CZP) differs from other anti-TNFα agents due to its limited placental transfer. In this study we assessed the efficacy of CZP in pregnant women with uveitis.
View Article and Find Full Text PDFEfficacy and safety of immunomodulatory drugs in patients with non-infectious intermediate and posterior uveitis, panuveitis and macular edema: A systematic literature review.
Semin Arthritis Rheum
December 2020
Background: Non-infectious non-anterior uveitis (NINA) is a sight-threatening condition that often requires immunomodulatory drugs (IMDs) for its management.
Objectives: To evaluate the published evidence regarding the use of IMDs in adult patients with NINA uveitis including intermediate (IU) and posterior uveitis (PU), panuveitis (PanU) and macular edema (ME).
Methods: We performed a systematic literature review.
: To assess the efficacy and safety of adalimumab in elderly patients with noninfectious uveitis (NIU).: An observational, retrospective, multicenter study was done. Changes in best-corrected visual acuity (BCVA), inflammatory activity parameters, central retinal thickness (CRT), and the occurrence of adverse events (AE) developed during follow-up were recorded.
View Article and Find Full Text PDFObjective: To generate recommendations on the use of immunomodulators in patients with non-infectious, non-neoplastic intermediate uveitis (IU), posterior uveitis (PU) and panuveitis (PanU) based on best evidence and experience.
Methods: A multidisciplinary panel of 5 experts was established, who defined the scope, users, and sections of the document. A systematic literature review (SLR) was performed to assess the efficacy and safety of immunomodulatory drugs in patients with non-infectious, non-neoplastic, non-anterior uveitis.
Article Synopsis
- The study aimed to evaluate the drug retention rate (DRR) and the factors influencing the discontinuation of adalimumab (ADA) treatment for noninfectious uveitis (NIU) in real-world settings across Spain.
- A total of 392 patients were analyzed, with a median follow-up of about 49 months, revealing a DRR of 93% at 6 months but dropping to about 54% after 5 years; discontinuation reasons included lack of efficacy and adverse events.
- The research employed various statistical methods to analyze predictors for discontinuation, finding that starting ADA in non-biotherapy-naive patients was associated with shorter drug retention time.
Objective: Discontinuation of interventional clinical trials and nonpublication of completed trials represent a waste of already scarce resources. We sought to identify the prevalence of discontinuation and nonpublication of interventional clinical trials conducted in ophthalmology patients.
Methods: A retrospective, cross-sectional study of ophthalmology-based interventional clinical trials in ClinicalTrials.
Objective: To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD).
Methods: We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement.
Birdshot Uveitis (Birdshot) is a rare eye condition that affects HLA-A29-positive individuals and could be considered a prototypic member of the recently proposed 'MHC-I (major histocompatibility complex class I)-opathy' family. Genetic studies have pinpointed the endoplasmic reticulum aminopeptidase (ERAP1) and (ERAP2) genes as shared associations across MHC-I-opathies, which suggests ERAP dysfunction may be a root cause for MHC-I-opathies. We mapped the ERAP1 and ERAP2 haplotypes in 84 Dutch cases and 890 controls.
View Article and Find Full Text PDFPurpose: To assess efficacy, safety, and cost-effectiveness of adalimumab (ADA) therapy optimization in a large series of patients with uveitis due to Behçet disease (BD) who achieved remission after the use of this biologic agent.
Design: Open-label multicenter study of ADA-treated patients with BD uveitis refractory to conventional immunosuppressants.
Subjects: Sixty-five of 74 patients with uveitis due to BD, who achieved remission after a median ADA duration of 6 (range, 3-12) months.
Objective: To assess the efficacy of tocilizumab (TCZ) in refractory uveitis of Behçet's disease (BD).
Methods: Multicentre study of patients with BD-associated uveitis. Patients were refractory to conventional and biologic immunosuppressive drugs.
Article Synopsis
- The study evaluated the effectiveness of golimumab, an anti-TNF-α monoclonal antibody, for treating refractory uveitis associated with juvenile idiopathic arthritis (JIA).
- It included 7 patients, most of whom had previously been treated with multiple other biologic agents, and showed significant improvements in ocular symptoms and visual acuity after 6 months of golimumab therapy.
- The results suggest that golimumab could be a valuable option in managing difficult cases of JIA-related uveitis, although some patients experienced insufficient response and needed alternative treatments.
Background: To assess the efficacy and safety of immunomodulatory drugs in patients with noninfectious anterior uveitis (AU).
Methods: Systematic review of studies were retrieved from Medline (1961 to March 2016), Embase (1961 to March 2016), and Cochrane Library (up to March 2016), and a complementary hand search was also performed. The selection criteria were as follows: (population) noninfectious AU patients, adults; (intervention) immunomodulatory drugs (any dose, regimen, route of administration, duration of treatment); (outcome) control of inflammation, steroid-sparing effect, AU flares, adverse events, and so on; (study design) systematic literature reviews, randomized controlled trials, and observational studies.
Background And Objective: To develop recommendations on the use of immunodepressors in patients with non-infectious, non-neoplastic anterior uveitis (AU) based on best evidence and experience.
Material And Methods: A multidisciplinary panel of five experts was established, who, in the first nominal group meeting defined the scope, users, and chapters of the document. A systematic literature review was performed to assess the efficacy and safety of immunosuppressors in patients with non-infectious, non-neoplastic AU.