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Real-World Treatment Patterns and Ocular Morbidity in Patients With Uveitic Macular Edema Secondary to Noninfectious Uveitis in the United States
Presenter:
Jia-Horung Hung, MD
Authors:
Jia-Horung Hung, MD, Quan Dong Nguyen, MD, MSc, Lu Chen, PhD, Parul Dayal, PhD, Navdeep Pal, MS, MPH, Ivo Stoilov, MD, Marina Mesquida, MD, MSc, PhD, Zdenka Haskova, MD, PhD, Laura Steeples, MBChB (Hons), FRCOphth
1. Jia-Horung Hung, MD
Affiliation: Byers Eye Institute, Stanford University, Palo Alto, CA
2. Quan Dong Nguyen, MD, MSc
Affiliation: Byers Eye Institute, Stanford University, Palo Alto, CA
3. Lu Chen, PhD
Affiliation: Genentech, Inc., South San Francisco, CA
4. Parul Dayal, PhD
Affiliation: Genentech, Inc., South San Francisco, CA
5. Navdeep Pal, MS, MPH
Affiliation: Genentech, Inc., South San Francisco, CA
6. Ivo Stoilov, MD
Affiliation: Genentech, Inc., South San Francisco, CA
7. Marina Mesquida, MD, MSc, PhD
Affiliation: F. Hoffmann-La Roche AG, Basel, Basel-Stadt, Switzerland
8. Zdenka Haskova, MD, PhD
Affiliation: Genentech, Inc., South San Francisco, CA
9. Laura Steeples, MBChB (Hons), FRCOphth
Affiliation: Roche Products Ltd., Welwyn, UK
Affiliation:
Purpose: To evaluate real-world treatment patterns in patients with noninfectious uveitis (NIU) and characterize the unmet need for new uveitic macular edema (UME) therapies.
Methods: Electronic health records (EHR) of patients treated by United States (US) retina specialists from the Vestrum Health® database were analyzed. Patients aged ≥ 18 years, with ≥ 2 separate NIU diagnoses within 120 days and ≥ 1 follow-up visit between 2017 and 2024 were included. NIU and UME were identified using relevant diagnosis codes and EHR supporting documentation. Local and systemic treatments were evaluated.
Results: Among 35,874 NIU eyes, 46% had a UME diagnosis. During the first year, both NIU and UME eyes were seen approximately once every 2 months (median, 17 and 19 months of follow-up, respectively). The most common treatments in both cohorts were topical steroids, intravitreal (IVT) dexamethasone implant (Ozurdex), and subtenon triamcinolone. Combined treatments were used as first-line therapy in 21% of NIU and 24% of UME eyes. At baseline, 63% of UME eyes were pseudophakic, yet 13% of phakic UME eyes underwent cataract surgery within 1 year. Glaucoma was prevalent at baseline in both NIU (21%) and UME (28%) eyes, and 13% of UME eyes developed new-onset glaucoma within 1 year. Visual acuity losses were observed: 20% (NIU) and 21% (UME) lost ≥ 5 letters, whereas 9% (NIU) and 10% (UME) lost ≥ 15 letters.
Conclusions: Locally administered corticosteroids remain the standard of care for NIU-related UME in the US; however, their adverse effects may limit long-term usage and increase ocular morbidity. The lack of noncorticosteroid local IVT therapies highlights a significant unmet need for effective, safer alternatives. Two global, randomized, controlled, identical phase 3 trials are currently investigating vamikibart, an IVT anti–interleukin-6 monoclonal antibody, in UME (MEERKAT, NCT05642312; SANDCAT, NCT05642325).