Use of MRI Screening Prior to Prescribing Adalimumab in Non-Infectious Uveitis (NIU)
Accept poster if oral is not possible ?
Yes
Purpose
VISUAL I, II and III trials proved the safety and efficacy of Adalimumab in treating and preventing relapse of NIU. Despite an association between anti-tumour necrosis factors medications and central nervous system demyelination, no established guidelines exist on screening patients prior to prescribing adalimumab. This audit reviews the use of MRI screening prior to prescribing Adalimumab in NIU, in a large tertiary centre.
Methods
Medical records of all 61 patients with NIU at Queen Elizabeth Hospital Birmingham UK (QEHB) were reviewed to collate demographic data and identify if MRI-screening for demyelination occurred, and if so, what protocol was requested.
Results
Patients started on Adalimumab pre-referral to QEHB or with a pre-existing MRI head for another indication were excluded. 16.3% of the remaining 43 patients underwent MRI-screening. Of these, the average age was 48 years, the Male:Female ratio was 71.4:28.6, and the proportion of each type of uveitis was: panuveitis (57.1%), anterior uveitis (14.3%), intermediate uveitis (14.3%) and posterior uveitis (14.3%). Type of MRI requested included: MRI head with contrast (57.1%), MRI head without contrast (28.6%) and MRI head/cervical spine with contrast (14.3%). No patients undergoing MRI-screening had retinal phlebitis, or a recorded neurological history, that would support MS as a possible cause.
Conclusion
Neither patient history nor uveitis subtype appears to correlate with a decision to screen for demyelination with MRI, and no consensus exists on the type of MRI to request. Consulting with neurology and radiology is needed to guide when, and how best, to screen for demyelination. This will aid development of an MRI screening protocol for Adalimumab.
Conflict of interest
No
1
Last name
OZA
Initials of first name(s)
R
Department
Resident Doctor (Foundation Training)
City
Birmingham
Country
United Kingdom
2
Last name
Balasubramaniam
Initials of first name(s)
B
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
3
Last name
Elsheikh
Initials of first name(s)
S
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
4
Last name
Skew
Initials of first name(s)
H
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
5
Last name
Agorogiannis
Initials of first name(s)
G
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
6
Last name
Patil
Initials of first name(s)
A
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
This website uses cookies to ensure you get the best experience on our website.
Learn more