Navigating the Use of RCI in the Management Of NIU: A Delphi Study
Presenter:
Quan Dong Nguyen, MD, MSc.
Authors:
Quan Dong Nguyen, MD, MSc, FAAO, Stephen D. Anesi, MD, FACS, Saradha Chexal, MD, David S. Chu, MD, Pouya N. Dayani, MD, Theodore Leng, MD, FACS, Dhanu Meleth, MD, Ahmed Sallam, MD, PhD, FRCOphth, John D. Sheppard, Jr., MD, Steven M. Silverstein, MD, FACS, Joseph Tauber, MD, Rolando Toyos, MD, Robert C. Wang, MD, C. Stephen Foster, MD, FACS, FACR
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Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California
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Massachusetts Eye Research & Surgery Institution (MERSI), Waltham, Massachusetts
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Retina Consultants of Austin, PA, Austin, Texas
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Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
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Metropolitan Eye Research and Surgery Institute, Palisades Park, New Jersey
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Retina‐Vitreous Associates Medical Group, Los Angeles, California
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Marietta Eye Clinic, Marietta, Georgia
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Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Virginia Eye Consultants, Norfolk, Virginia
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University of Missouri Kansas City School of Medicine, Kansas City, Missouri
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Tauber Eye Center, Kansas City, Missouri
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Toyos Clinic, Germantown, Tennessee
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Texas Retina Associates, Dallas, Texas
Affiliation:
Purpose: Noninfectious uveitis (NIU) is a rare inflammatory condition associated with a high risk of significant visual loss. Corticosteroids are a mainstay of acute NIU management but are not appropriate for long‐ term therapy because of their well‐known side effects. As a result, a variety of systemic immunomodulatory therapies are also used in managing refractory NIU, many of which are not FDA approved for the treatment of NIU. Repository corticotropin injection (RCI) has received FDA approval for treatment of severe acute and chronic allergic and inflammatory processes involving the eye and is an option for treating NIU.
Only limited clinical data on the use of RCI in NIU are available. We formed a panel of uveitis specialists experienced with RCI in NIU and used a modified Delphi process to develop consensus recommendations on patient selection, dosing, and adverse event management for RCI in the treatment of NIU. Given the lack of clinical evidence, these recommendations may be useful to clinicians who manage NIU.