Use of microperimetry to evaluate hydroxychloroquine and chloroquine retinal toxicity

To check the ability of microperimetry to detect early retinal damage in patients with rheumatism taking hydroxychloroquine (HCQ), chloroquine (CQ), or both, and to describe the microperimetric alterations attributable to these drugs and their correlation with some clinical variables

Long-term follow-up of certolizumab pegol in uveitis due to immune-mediated inflammatory diseases: multicentre study of 80 patients

Objectives: 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. These variables were compared between the baseline, and first week, first, third, sixth months, first and second year. Results: We studied 80 (33 men/47 women) patients (111 affected eyes) with a mean age of 41.6±11.7 years. The IMID included were: spondyloarthritis (n=43), Behçet's disease (n=10), psoriatic arthritis (n=8), Crohn's disease (n=4), sarcoidosis (n=2), juvenile idiopathic arthritis (n=1), reactive arthritis (n=1), rheumatoid arthritis (n=1), relapsing polychondritis (n=1), CONCLUSIONS: CZP seems to be effective and safe in uveitis related to different IMID, even in patients refractory to previous biological drugs.Funding: This work was also partially supported by RETICS Programmes, RD08/0075 (RIER) and RD12/0009/0013 from 'Instituto de Salud Carlos III' (ISCIII) (Spain)

Development of an activity disease score in patients with uveitis (UVEDAI)

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct "uveitis inflammatory activity" was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases

Rituximab: eficacia y seguridad a corto plazo en pacientes con lupus eritematoso sistémico

El pronóstico del lupus eritematoso sistémico (LES) ha mejorado considerablemente en los últimos años debido, en parte, a la aparición de nuevos tratamientos. El objetivo del presente estudio es la revisión retrospectiva de los resultados obtenidos de eficacia y seguridad tras la administración de Rituximab (RTX) en pacientes con LES que previamente habían respondido de forma insatisfactoria a tratamiento convencional con corticoides e inmunosupresores. Material y método: se incluyeron 6 pacientes con diversas manifestaciones clínicas. Las indicaciones de tratamiento fueron: nefropatía membranoproliferativa refractaria a tratamiento secuencial con ciclofosfamida, altas dosis de corticoides y micofenolato (2 pacientes), poliartritis con respuesta insatisfactoria a antipalúdicos, leflunomida y metotrexato (3 pacientes) y un paciente tenía un síndrome antifosfolípido catastrófico. La actividad de la enfermedad fue evaluada por el Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Resultados: la respuesta fue considerada satisfactoria en 4. La media de SLEDAI disminuyó de 10 a 5.2 puntos. RTX fue bien tolerado por todos los pacientes sin observarse efectos secundarios significativos. Conclusión: RTX se presenta como una alternativa válida en el tratamiento de pacientes con LES que han fracasado a otros tratamientos convencionales