Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic.
Identifieur interne : 000577 ( Main/Exploration ); précédent : 000576; suivant : 000578Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic.
Auteurs : Rupesh Agrawal [Singapour, Royaume-Uni] ; Ilaria Testi [Royaume-Uni] ; Cecilia S. Lee [États-Unis] ; Edmund Tsui [États-Unis] ; Marian Blazes [États-Unis] ; Jennifer E. Thorne [États-Unis] ; Annabelle A. Okada [Japon] ; Justine R. Smith [Australie] ; Peter J. Mccluskey [Australie] ; John H. Kempen [États-Unis, Éthiopie] ; Christoph Tappeiner [Suisse] ; Manisha Agarwal [Inde] ; Bahram Bodaghi [France] ; Quan Dong Nguyen [États-Unis] ; Vishali Gupta [Inde] ; Marc D. De Smet [Belgique] ; Manfred Zierhut [Allemagne] ; Carlos Pavesio [Royaume-Uni]Source :
- The British journal of ophthalmology [ 1468-2079 ] ; 2020.
Abstract
BACKGROUND
Immunomodulatory therapy (IMT) is often considered for systemic treatment of non-infectious uveitis (NIU). During the evolving coronavirus disease-2019 (COVID-19) pandemic, given the concerns related to IMT and the increased risk of infections, an urgent need for guidance on the management of IMT in patients with uveitis has emerged.
METHODS
A cross-sectional survey of international uveitis experts was conducted. An expert steering committee identified clinical questions on the use of IMT in patients with NIU during the COVID-19 pandemic. Using an interactive online questionnaire, guided by background experience and knowledge, 139 global uveitis experts generated consensus statements for IMT. In total, 216 statements were developed around when to initiate, continue, decrease and stop systemic and local corticosteroids, conventional immunosuppressive agents and biologics in patients with NIU. Thirty-one additional questions were added, related to general recommendations, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hydroxychloroquine.
RESULTS
Highest consensus was achieved for not initiating IMT in patients who have suspected or confirmed COVID-19, and for using local over systemic corticosteroid therapy in patients who are at high-risk and very high-risk for severe or fatal COVID-19. While there was a consensus in starting or initiating NSAIDs for the treatment of scleritis in healthy patients, there was no consensus in starting hydroxychloroquine in any risk groups.
CONCLUSION
Consensus guidelines were proposed based on global expert opinion and practical experience to bridge the gap between clinical needs and the absence of medical evidence, to guide the treatment of patients with NIU during the COVID-19 pandemic.
DOI: 10.1136/bjophthalmol-2020-316776
PubMed: 32586933
PubMed Central: PMC7313529
Affiliations:
- Allemagne, Australie, Belgique, France, Inde, Japon, Royaume-Uni, Singapour, Suisse, États-Unis, Éthiopie
- Angleterre, Bade-Wurtemberg, Californie, Canton de Berne, District de Tübingen, Grand Londres, Maryland, Massachusetts, Nouvelle-Galles du Sud, Washington (État), Île-de-France
- Baltimore, Berne, Boston, Londres, Los Angeles, Paris, Seattle, Stanford (Californie), Sydney, Tübingen
- Université de Sydney, Université de Washington
Links toward previous steps (curation, corpus...)
Le document en format XML
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Okada</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, New South Wales, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, New South Wales</wicri:regionArea><wicri:noRegion>New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Smith, Justine R" sort="Smith, Justine R" uniqKey="Smith J" first="Justine R" last="Smith">Justine R. Smith</name><affiliation wicri:level="1"><nlm:affiliation>Flinders University College of Medicine and Public Health, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Flinders University College of Medicine and Public Health, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Mccluskey, Peter J" sort="Mccluskey, Peter J" uniqKey="Mccluskey P" first="Peter J" last="Mccluskey">Peter J. Mccluskey</name><affiliation wicri:level="4"><nlm:affiliation>Department of Ophthalmology, Director Save Sight Institute, The University of Sydney, Sydney, Pennsylvania, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Ophthalmology, Director Save Sight Institute, The University of Sydney, Sydney, Pennsylvania</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Kempen, John H" sort="Kempen, John H" uniqKey="Kempen J" first="John H" last="Kempen">John H. Kempen</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Eye Unit, MyungSung Christian Medical Center, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.</nlm:affiliation><country xml:lang="fr">Éthiopie</country><wicri:regionArea>Eye Unit, MyungSung Christian Medical Center, MCM General Hospital and MyungSung Medical School, Addis Ababa</wicri:regionArea><wicri:noRegion>Addis Ababa</wicri:noRegion></affiliation></author><author><name sortKey="Tappeiner, Christoph" sort="Tappeiner, Christoph" uniqKey="Tappeiner C" first="Christoph" last="Tappeiner">Christoph Tappeiner</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Agarwal, Manisha" sort="Agarwal, Manisha" uniqKey="Agarwal M" first="Manisha" last="Agarwal">Manisha Agarwal</name><affiliation wicri:level="1"><nlm:affiliation>Shroff Eye Centre, New Delhi, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Shroff Eye Centre, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Bodaghi, Bahram" sort="Bodaghi, Bahram" uniqKey="Bodaghi B" first="Bahram" last="Bodaghi">Bahram Bodaghi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology,, Sorbonne University, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Ophthalmology,, Sorbonne University, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Nguyen, Quan Dong" sort="Nguyen, Quan Dong" uniqKey="Nguyen Q" first="Quan Dong" last="Nguyen">Quan Dong Nguyen</name><affiliation wicri:level="3"><nlm:affiliation>Byers Eye Institute, Stanford Medical School, Stanford, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Byers Eye Institute, Stanford Medical School, Stanford</wicri:regionArea><placeName><settlement type="city">Stanford (Californie)</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Gupta, Vishali" sort="Gupta, Vishali" uniqKey="Gupta V" first="Vishali" last="Gupta">Vishali Gupta</name><affiliation wicri:level="1"><nlm:affiliation>Advanced Eye Centre, Postgraduate Institute of Medical Education (PGIMER), Chandigarh, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Advanced Eye Centre, Postgraduate Institute of Medical Education (PGIMER), Chandigarh</wicri:regionArea><wicri:noRegion>Chandigarh</wicri:noRegion></affiliation></author><author><name sortKey="De Smet, Marc D" sort="De Smet, Marc D" uniqKey="De Smet M" first="Marc D" last="De Smet">Marc D. De Smet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology ZNA Middelheim, Antwerp, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Ophthalmology ZNA Middelheim, Antwerp</wicri:regionArea><wicri:noRegion>Antwerp</wicri:noRegion></affiliation></author><author><name sortKey="Zierhut, Manfred" sort="Zierhut, Manfred" uniqKey="Zierhut M" first="Manfred" last="Zierhut">Manfred Zierhut</name><affiliation wicri:level="3"><nlm:affiliation>Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Centre of Ophthalmology, University of Tuebingen, Tuebingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Pavesio, Carlos" sort="Pavesio, Carlos" uniqKey="Pavesio C" first="Carlos" last="Pavesio">Carlos Pavesio</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32586933</idno><idno type="pmid">32586933</idno><idno type="doi">10.1136/bjophthalmol-2020-316776</idno><idno type="pmc">PMC7313529</idno><idno type="wicri:Area/Main/Corpus">000567</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000567</idno><idno type="wicri:Area/Main/Curation">000567</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000567</idno><idno type="wicri:Area/Main/Exploration">000567</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic.</title><author><name sortKey="Agrawal, Rupesh" sort="Agrawal, Rupesh" uniqKey="Agrawal R" first="Rupesh" last="Agrawal">Rupesh Agrawal</name><affiliation wicri:level="1"><nlm:affiliation>National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore rupesh_agrawal@ttsh.com.sg c.pavesio@nhs.net ndquan@stanford.edu.</nlm:affiliation><country wicri:rule="url">Singapour</country><wicri:regionArea>National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Singapore Eye Research Institute, Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Singapore Eye Research Institute, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>School of Material Science and Engineering, Nanyang Technological University, Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>School of Material Science and Engineering, Nanyang Technological University, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Testi, Ilaria" sort="Testi, Ilaria" uniqKey="Testi I" first="Ilaria" last="Testi">Ilaria Testi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lee, Cecilia S" sort="Lee, Cecilia S" uniqKey="Lee C" first="Cecilia S" last="Lee">Cecilia S. Lee</name><affiliation wicri:level="4"><nlm:affiliation>Department of Ophthalmology, University of Washington, Seattle, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, University of Washington, Seattle</wicri:regionArea><orgName type="university">Université de Washington</orgName><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Tsui, Edmund" sort="Tsui, Edmund" uniqKey="Tsui E" first="Edmund" last="Tsui">Edmund Tsui</name><affiliation wicri:level="3"><nlm:affiliation>UCLA Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>UCLA Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California, Los Angeles</wicri:regionArea><placeName><settlement type="city">Los Angeles</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Blazes, Marian" sort="Blazes, Marian" uniqKey="Blazes M" first="Marian" last="Blazes">Marian Blazes</name><affiliation wicri:level="4"><nlm:affiliation>Department of Ophthalmology, University of Washington, Seattle, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, University of Washington, Seattle</wicri:regionArea><orgName type="university">Université de Washington</orgName><placeName><settlement type="city">Seattle</settlement><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Thorne, Jennifer E" sort="Thorne, Jennifer E" uniqKey="Thorne J" first="Jennifer E" last="Thorne">Jennifer E. Thorne</name><affiliation wicri:level="3"><nlm:affiliation>Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA, Baltimore.</nlm:affiliation><country>États-Unis</country><placeName><settlement type="city">Baltimore</settlement><region type="state">Maryland</region></placeName><wicri:orgArea>Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA</wicri:orgArea></affiliation></author><author><name sortKey="Okada, Annabelle A" sort="Okada, Annabelle A" uniqKey="Okada A" first="Annabelle A" last="Okada">Annabelle A. Okada</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, New South Wales, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, New South Wales</wicri:regionArea><wicri:noRegion>New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Smith, Justine R" sort="Smith, Justine R" uniqKey="Smith J" first="Justine R" last="Smith">Justine R. Smith</name><affiliation wicri:level="1"><nlm:affiliation>Flinders University College of Medicine and Public Health, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Flinders University College of Medicine and Public Health, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Mccluskey, Peter J" sort="Mccluskey, Peter J" uniqKey="Mccluskey P" first="Peter J" last="Mccluskey">Peter J. Mccluskey</name><affiliation wicri:level="4"><nlm:affiliation>Department of Ophthalmology, Director Save Sight Institute, The University of Sydney, Sydney, Pennsylvania, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Ophthalmology, Director Save Sight Institute, The University of Sydney, Sydney, Pennsylvania</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Kempen, John H" sort="Kempen, John H" uniqKey="Kempen J" first="John H" last="Kempen">John H. Kempen</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Eye Unit, MyungSung Christian Medical Center, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.</nlm:affiliation><country xml:lang="fr">Éthiopie</country><wicri:regionArea>Eye Unit, MyungSung Christian Medical Center, MCM General Hospital and MyungSung Medical School, Addis Ababa</wicri:regionArea><wicri:noRegion>Addis Ababa</wicri:noRegion></affiliation></author><author><name sortKey="Tappeiner, Christoph" sort="Tappeiner, Christoph" uniqKey="Tappeiner C" first="Christoph" last="Tappeiner">Christoph Tappeiner</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Agarwal, Manisha" sort="Agarwal, Manisha" uniqKey="Agarwal M" first="Manisha" last="Agarwal">Manisha Agarwal</name><affiliation wicri:level="1"><nlm:affiliation>Shroff Eye Centre, New Delhi, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Shroff Eye Centre, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Bodaghi, Bahram" sort="Bodaghi, Bahram" uniqKey="Bodaghi B" first="Bahram" last="Bodaghi">Bahram Bodaghi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology,, Sorbonne University, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Ophthalmology,, Sorbonne University, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Nguyen, Quan Dong" sort="Nguyen, Quan Dong" uniqKey="Nguyen Q" first="Quan Dong" last="Nguyen">Quan Dong Nguyen</name><affiliation wicri:level="3"><nlm:affiliation>Byers Eye Institute, Stanford Medical School, Stanford, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Byers Eye Institute, Stanford Medical School, Stanford</wicri:regionArea><placeName><settlement type="city">Stanford (Californie)</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Gupta, Vishali" sort="Gupta, Vishali" uniqKey="Gupta V" first="Vishali" last="Gupta">Vishali Gupta</name><affiliation wicri:level="1"><nlm:affiliation>Advanced Eye Centre, Postgraduate Institute of Medical Education (PGIMER), Chandigarh, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Advanced Eye Centre, Postgraduate Institute of Medical Education (PGIMER), Chandigarh</wicri:regionArea><wicri:noRegion>Chandigarh</wicri:noRegion></affiliation></author><author><name sortKey="De Smet, Marc D" sort="De Smet, Marc D" uniqKey="De Smet M" first="Marc D" last="De Smet">Marc D. De Smet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology ZNA Middelheim, Antwerp, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Ophthalmology ZNA Middelheim, Antwerp</wicri:regionArea><wicri:noRegion>Antwerp</wicri:noRegion></affiliation></author><author><name sortKey="Zierhut, Manfred" sort="Zierhut, Manfred" uniqKey="Zierhut M" first="Manfred" last="Zierhut">Manfred Zierhut</name><affiliation wicri:level="3"><nlm:affiliation>Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Centre of Ophthalmology, University of Tuebingen, Tuebingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Pavesio, Carlos" sort="Pavesio, Carlos" uniqKey="Pavesio C" first="Carlos" last="Pavesio">Carlos Pavesio</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">The British journal of ophthalmology</title><idno type="eISSN">1468-2079</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Immunomodulatory therapy (IMT) is often considered for systemic treatment of non-infectious uveitis (NIU). During the evolving coronavirus disease-2019 (COVID-19) pandemic, given the concerns related to IMT and the increased risk of infections, an urgent need for guidance on the management of IMT in patients with uveitis has emerged.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A cross-sectional survey of international uveitis experts was conducted. An expert steering committee identified clinical questions on the use of IMT in patients with NIU during the COVID-19 pandemic. Using an interactive online questionnaire, guided by background experience and knowledge, 139 global uveitis experts generated consensus statements for IMT. In total, 216 statements were developed around when to initiate, continue, decrease and stop systemic and local corticosteroids, conventional immunosuppressive agents and biologics in patients with NIU. Thirty-one additional questions were added, related to general recommendations, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hydroxychloroquine.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Highest consensus was achieved for not initiating IMT in patients who have suspected or confirmed COVID-19, and for using local over systemic corticosteroid therapy in patients who are at high-risk and very high-risk for severe or fatal COVID-19. While there was a consensus in starting or initiating NSAIDs for the treatment of scleritis in healthy patients, there was no consensus in starting hydroxychloroquine in any risk groups.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Consensus guidelines were proposed based on global expert opinion and practical experience to bridge the gap between clinical needs and the absence of medical evidence, to guide the treatment of patients with NIU during the COVID-19 pandemic.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32586933</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-2079</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jun</Month><Day>25</Day></PubDate></JournalIssue><Title>The British journal of ophthalmology</Title><ISOAbbreviation>Br J Ophthalmol</ISOAbbreviation></Journal><ArticleTitle>Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">bjophthalmol-2020-316776</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/bjophthalmol-2020-316776</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Immunomodulatory therapy (IMT) is often considered for systemic treatment of non-infectious uveitis (NIU). During the evolving coronavirus disease-2019 (COVID-19) pandemic, given the concerns related to IMT and the increased risk of infections, an urgent need for guidance on the management of IMT in patients with uveitis has emerged.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A cross-sectional survey of international uveitis experts was conducted. An expert steering committee identified clinical questions on the use of IMT in patients with NIU during the COVID-19 pandemic. Using an interactive online questionnaire, guided by background experience and knowledge, 139 global uveitis experts generated consensus statements for IMT. In total, 216 statements were developed around when to initiate, continue, decrease and stop systemic and local corticosteroids, conventional immunosuppressive agents and biologics in patients with NIU. Thirty-one additional questions were added, related to general recommendations, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hydroxychloroquine.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Highest consensus was achieved for not initiating IMT in patients who have suspected or confirmed COVID-19, and for using local over systemic corticosteroid therapy in patients who are at high-risk and very high-risk for severe or fatal COVID-19. While there was a consensus in starting or initiating NSAIDs for the treatment of scleritis in healthy patients, there was no consensus in starting hydroxychloroquine in any risk groups.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Consensus guidelines were proposed based on global expert opinion and practical experience to bridge the gap between clinical needs and the absence of medical evidence, to guide the treatment of patients with NIU during the COVID-19 pandemic.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Agrawal</LastName><ForeName>Rupesh</ForeName><Initials>R</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-6662-5850</Identifier><AffiliationInfo><Affiliation>National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore rupesh_agrawal@ttsh.com.sg c.pavesio@nhs.net ndquan@stanford.edu.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Singapore Eye Research Institute, Singapore, Singapore.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Material Science and Engineering, Nanyang Technological University, Singapore, Singapore.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Testi</LastName><ForeName>Ilaria</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Cecilia S</ForeName><Initials>CS</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, University of Washington, Seattle, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tsui</LastName><ForeName>Edmund</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>UCLA Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blazes</LastName><ForeName>Marian</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, University of Washington, Seattle, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thorne</LastName><ForeName>Jennifer E</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA, Baltimore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Okada</LastName><ForeName>Annabelle A</ForeName><Initials>AA</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, New South Wales, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Justine R</ForeName><Initials>JR</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-4756-5493</Identifier><AffiliationInfo><Affiliation>Flinders University College of Medicine and Public Health, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McCluskey</LastName><ForeName>Peter J</ForeName><Initials>PJ</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, Director Save Sight Institute, The University of Sydney, Sydney, Pennsylvania, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kempen</LastName><ForeName>John H</ForeName><Initials>JH</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-2967-4792</Identifier><AffiliationInfo><Affiliation>Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Eye Unit, MyungSung Christian Medical Center, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tappeiner</LastName><ForeName>Christoph</ForeName><Initials>C</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-6907-1112</Identifier><AffiliationInfo><Affiliation>Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agarwal</LastName><ForeName>Manisha</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Shroff Eye Centre, New Delhi, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bodaghi</LastName><ForeName>Bahram</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology,, Sorbonne University, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Quan Dong</ForeName><Initials>QD</Initials><AffiliationInfo><Affiliation>Byers Eye Institute, Stanford Medical School, Stanford, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gupta</LastName><ForeName>Vishali</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Advanced Eye Centre, Postgraduate Institute of Medical Education (PGIMER), Chandigarh, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Smet</LastName><ForeName>Marc D</ForeName><Initials>MD</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-9217-5603</Identifier><AffiliationInfo><Affiliation>Department of Ophthalmology ZNA Middelheim, Antwerp, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zierhut</LastName><ForeName>Manfred</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pavesio</LastName><ForeName>Carlos</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Medical Retina and Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>COVID-19 IMT Study Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Br J Ophthalmol</MedlineTA><NlmUniqueID>0421041</NlmUniqueID><ISSNLinking>0007-1161</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Choroid</Keyword><Keyword MajorTopicYN="N">Ciliary body</Keyword><Keyword MajorTopicYN="N">Conjunctiva</Keyword><Keyword MajorTopicYN="N">Cornea</Keyword><Keyword MajorTopicYN="N">Drugs</Keyword><Keyword MajorTopicYN="N">Epidemiology</Keyword><Keyword MajorTopicYN="N">Imaging</Keyword><Keyword MajorTopicYN="N">Immunology</Keyword><Keyword MajorTopicYN="N">Infection</Keyword><Keyword MajorTopicYN="N">Inflammation</Keyword><Keyword MajorTopicYN="N">Iris</Keyword><Keyword MajorTopicYN="N">Macula</Keyword><Keyword MajorTopicYN="N">Retina</Keyword><Keyword MajorTopicYN="N">Telemedicine</Keyword><Keyword MajorTopicYN="N">Treatment lasers</Keyword><Keyword MajorTopicYN="N">Treatment medical</Keyword><Keyword MajorTopicYN="N">Vitreous</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>6</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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(État)</li><li>Île-de-France</li></region><settlement><li>Baltimore</li><li>Berne</li><li>Boston</li><li>Londres</li><li>Los Angeles</li><li>Paris</li><li>Seattle</li><li>Stanford (Californie)</li><li>Sydney</li><li>Tübingen</li></settlement><orgName><li>Université de Sydney</li><li>Université de Washington</li></orgName></list><tree><country name="Singapour"><noRegion><name sortKey="Agrawal, Rupesh" sort="Agrawal, Rupesh" uniqKey="Agrawal R" first="Rupesh" last="Agrawal">Rupesh Agrawal</name></noRegion><name sortKey="Agrawal, Rupesh" sort="Agrawal, Rupesh" uniqKey="Agrawal R" first="Rupesh" last="Agrawal">Rupesh Agrawal</name><name sortKey="Agrawal, Rupesh" sort="Agrawal, Rupesh" uniqKey="Agrawal R" first="Rupesh" last="Agrawal">Rupesh Agrawal</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Agrawal, Rupesh" sort="Agrawal, Rupesh" uniqKey="Agrawal R" first="Rupesh" last="Agrawal">Rupesh Agrawal</name></region><name sortKey="Pavesio, Carlos" sort="Pavesio, Carlos" uniqKey="Pavesio C" first="Carlos" last="Pavesio">Carlos Pavesio</name><name sortKey="Testi, Ilaria" sort="Testi, Ilaria" uniqKey="Testi I" first="Ilaria" last="Testi">Ilaria Testi</name></country><country name="États-Unis"><region name="Washington (État)"><name sortKey="Lee, Cecilia S" sort="Lee, Cecilia S" uniqKey="Lee C" first="Cecilia S" last="Lee">Cecilia S. Lee</name></region><name sortKey="Blazes, Marian" sort="Blazes, Marian" uniqKey="Blazes M" first="Marian" last="Blazes">Marian Blazes</name><name sortKey="Kempen, John H" sort="Kempen, John H" uniqKey="Kempen J" first="John H" last="Kempen">John H. Kempen</name><name sortKey="Nguyen, Quan Dong" sort="Nguyen, Quan Dong" uniqKey="Nguyen Q" first="Quan Dong" last="Nguyen">Quan Dong Nguyen</name><name sortKey="Thorne, Jennifer E" sort="Thorne, Jennifer E" uniqKey="Thorne J" first="Jennifer E" last="Thorne">Jennifer E. Thorne</name><name sortKey="Tsui, Edmund" sort="Tsui, Edmund" uniqKey="Tsui E" first="Edmund" last="Tsui">Edmund Tsui</name></country><country name="Japon"><noRegion><name sortKey="Okada, Annabelle A" sort="Okada, Annabelle A" uniqKey="Okada A" first="Annabelle A" last="Okada">Annabelle A. Okada</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Smith, Justine R" sort="Smith, Justine R" uniqKey="Smith J" first="Justine R" last="Smith">Justine R. Smith</name></noRegion><name sortKey="Mccluskey, Peter J" sort="Mccluskey, Peter J" uniqKey="Mccluskey P" first="Peter J" last="Mccluskey">Peter J. Mccluskey</name></country><country name="Éthiopie"><noRegion><name sortKey="Kempen, John H" sort="Kempen, John H" uniqKey="Kempen J" first="John H" last="Kempen">John H. Kempen</name></noRegion></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Tappeiner, Christoph" sort="Tappeiner, Christoph" uniqKey="Tappeiner C" first="Christoph" last="Tappeiner">Christoph Tappeiner</name></region></country><country name="Inde"><noRegion><name sortKey="Agarwal, Manisha" sort="Agarwal, Manisha" uniqKey="Agarwal M" first="Manisha" last="Agarwal">Manisha Agarwal</name></noRegion><name sortKey="Gupta, Vishali" sort="Gupta, Vishali" uniqKey="Gupta V" first="Vishali" last="Gupta">Vishali Gupta</name></country><country name="France"><region name="Île-de-France"><name sortKey="Bodaghi, Bahram" sort="Bodaghi, Bahram" uniqKey="Bodaghi B" first="Bahram" last="Bodaghi">Bahram Bodaghi</name></region></country><country name="Belgique"><noRegion><name sortKey="De Smet, Marc D" sort="De Smet, Marc D" uniqKey="De Smet M" first="Marc D" last="De Smet">Marc D. De Smet</name></noRegion></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Zierhut, Manfred" sort="Zierhut, Manfred" uniqKey="Zierhut M" first="Manfred" last="Zierhut">Manfred Zierhut</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/CovidStanfordV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000577 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000577 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= CovidStanfordV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:32586933
|texte= Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:32586933" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidStanfordV1
| This area was generated with Dilib version V0.6.38. |  |