Health- and Vision-Related Quality of Life in a Randomized Controlled Trial Comparing Methotrexate and Mycophenolate Mofetil for Uveitis.

Autor:	Kelly NK; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California., Chattopadhyay A; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California., Rathinam SR; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India., Gonzales JA; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California., Thundikandy R; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India., Kanakath A; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Coimbatore, India., Murugan SB; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India., Vedhanayaki R; Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India., Cugley D; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia., Lim LL; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia., Suhler EB; Casey Eye Institute, Oregon Health and Science University, OHSU-PSU School of Public Health, and Portland Veterans' Affairs Health Care System, Portland, Oregon., Al-Dhibi HA; Division of Vitreoretinal Surgery and Uveitis, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia., Ebert CD; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California., Berlinberg EJ; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California., Porco TC; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California., Acharya NR; F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California. Electronic address: nisha.acharya@ucsf.edu.
Jazyk:	angličtina
Zdroj:	Ophthalmology [Ophthalmology] 2021 Sep; Vol. 128 (9), pp. 1337-1345. Date of Electronic Publication: 2021 Mar 04.
DOI:	10.1016/j.ophtha.2021.02.024
Abstrakt:	Purpose: To evaluate changes in health-related and vision-related quality of life (VRQoL) among patients with noninfectious uveitis who were treated with antimetabolites. Design: Secondary analysis of a randomized controlled trial. Participants: Patients with noninfectious uveitis from India, the United States, Australia, Saudi Arabia, and Mexico. Methods: From 2013 through 2017, 216 participants were randomized to receive 25 mg weekly oral methotrexate or 1.5 g twice daily oral mycophenolate mofetil. Median changes in quality of life (QoL) were measured using Wilcoxon signed-rank tests, and differences between treatment groups were measured using linear mixed models, adjusting for baseline QoL score, age, gender, and site. Among Indian patients, VRQoL scores from a general scale (the National Eye Institute Visual Function Questionnaire [NEI-VFQ]) and a culturally specific scale (the Indian Visual Function Questionnaire [IND-VFQ]) were compared using Pearson correlation tests. Main Outcome Measures: Vision-related QoL (NEI-VFQ and IND-VFQ) and health-related QoL (HRQoL; physical component score [PCS] and mental component score [MCS] of the Medical Outcomes Study 36-Item Short Form Survey [SF-36v2]) were measured at baseline, the primary end point (6 months or treatment failure before 6 months), and the secondary end point (12 months or treatment failure between 6 and 12 months). Results: Among 193 participants who reached the primary end point, VRQoL increased from baseline by a median of 12.0 points (interquartile range [IQR], 1.0-26.1, NEI-VFQ scale), physical HRQoL increased by a median of 3.6 points (IQR, -1.4 to 14.9, PCS SF-36v2), and mental HRQoL increased by a median of 3.0 points (IQR, -3.7 to 11.9, MCS SF-36v2). These improvements in NEI-VFQ, SF-36v2 PCS, and SF-36v2 MCS scores all were significant (P < 0.01). The linear mixed models showed that QoL did not differ between treatment groups for each QoL assessment (NEI-VFQ, IND-VFQ, PCS SF-36v2, and MCS SF-36v2; P > 0.05 for all). The NEI-VFQ and IND-VFQ scores for Indian participants were correlated highly at baseline and the primary and secondary end points (correlation coefficients, 0.87, 0.80, and 0.90, respectively). Conclusions: Among patients treated with methotrexate or mycophenolate mofetil for uveitis, VRQoL and HRQoL improved significantly over the course of 1 year and did not differ by treatment allocation. These findings suggest that antimetabolites could improve overall patient well-being and daily functioning. (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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