Would this patient benefit from treatment other than steroids?
In today's journal club, we review a paper from Jaffe et al which is published in the NEJM. The study was designed to determine if uveitis patients who required prednisone would benefit from a systemic agent (anti-TNF-alpha agent).
This was a phase 3 clinical trial in which patients were randomized to either Adalimumab or placebo. Both groups received a burst of prednisone which was tapered over 15 weeks.
The researchers noted a prevalence a 50% reduction in recurrence; the time to recurrence was 13 weeks in the placebo group and 23 in the treatment group.
In this journal club's accompanying 13 min. video, we'll review:
- The adverse events associated with systemic steroids
- The adverse events associated with topical steroids
- How to interpret a relative risk
Jin Yang, Qinqin Zhang, Elie H. Motulsky, Marie Thulliez, Yingying Shi, Cancan Lyu, Luis de Sisternes, Mary K. Durbin, William Feuer, Ruikang K. Wang, Giovanni Gregori, Philip J. Rosenfeld. Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography. Am J Ophthalmol. Author manuscript; available in PMC 2020