Development of an activity disease score in patients with uveitis (UVEDAI)

Abstract

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct “uveitis inflammatory activity” was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3593-1) contains supplementary material, which is available to authorized users.

Proposal for a definition for response to treatment, inactive disease and damage for JIA associated uveitis based on the validation of a uveitis related JIA outcome measures from the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC)

“…Recent efficacy and health economic and drug efficacy studies have used additional measures and different time scales – it might be helpful to construct a single measure for all purposes such as the JADAS ( Juvenile Arthritis Disease Activity Score) scoring systems in JIA. A construct of “uveitis inflammatory activity” “UVEDAI”, for adult uveitis has been proposed, and some items used in this study are identical such as anterior chamber cell grade, vitreous haze, macula edema and patient-reported evaluations [31]. It does not include severity and damage items or a patient/parent global assessment.…”

Are Patients at Risk for Recurrent Disease Activity After Switching From Remicade® to Remsima®? An Observational Study

“…The incidence of increased disease activity scores (n = 7) and significant adverse events (n = 5) were 14•6% (7/48) and 10•4% (5/48), respectively, based on the full analysis set (n = 48) (Figure 3). Supplementary Tables 4, 5, respectively demonstrate the disease activity index measured with Behcet's disease current activity form (19) and Uveitis disease activity index (20) during the first 6 months.…”

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis

“…Although there is considerable heterogeneity, 20,31,33,35,49,71 clinical criteria with the strongest evidence supporting their usefulness in adjusting systemic therapy (where the eye is the major organ affected in systemic disease and decisions are led by the ophthalmologist) are visual acuity (VA) and ocular inflammation, as defined by Standardization of Uveitis Nomenclature Working Group criteria. 1 A recent Delphi panel developed the Uveitis Disease Activity Index to assess global ocular inflammatory activity in patients with uveitis; 72 however, this has not yet been validated as a method to assess the need for therapeutic adjustment. Given that uveitides comprise several distinct diseases, assessments that are more specific to different forms of disease also may be desirable.…”