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Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis.
- Source :
-
American journal of ophthalmology [Am J Ophthalmol] 2017 Jul; Vol. 179, pp. 10-17. Date of Electronic Publication: 2017 Apr 14. - Publication Year :
- 2017
-
Abstract
- Purpose: To evaluate the changes in quality of life in noninfectious uveitis patients treated with 2 of the most commonly prescribed antimetabolite treatments.<br />Design: Secondary analysis of a multicenter, block-randomized clinical trial.<br />Methods: Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, Indian Vision Function Questionnaire (IND-VFQ), and Medical Outcomes Study 36-item Short Form Survey (SF-36) were obtained at enrollment and at 6 months (or prior, in the event of early treatment failure).<br />Results: IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% confidence interval [CI]: 4.9, 13.5, P = .0001). Although the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: -4.4, -0.1, P = .04) and the vitality subscale decreased by 3.5 points (95% CI: -5.6, -1.4, P = .001). Quality-of-life scores did not differ between treatment arms. Linear regression modeling showed a 3.2-point improvement in IND-VFQ score for every 5-letter improvement in visual acuity (95% CI: 1.9, 4.3; P < .001).<br />Conclusions: Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Oral
Adult
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Male
Panuveitis psychology
Treatment Outcome
Uveitis, Posterior psychology
Antimetabolites administration & dosage
Health Status
Panuveitis drug therapy
Quality of Life
Surveys and Questionnaires
Uveitis, Posterior drug therapy
Visual Acuity
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1891
- Volume :
- 179
- Database :
- MEDLINE
- Journal :
- American journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 28414043
- Full Text :
- https://doi.org/10.1016/j.ajo.2017.04.003