Real-World Experience of Fluocinolone Acetonide 0.19 mg in the Management of Non-Infectious Uveitis

ABSTRACT

Purpose

This study aims to evaluate the real-world efficacy and safety profile of fluocinolone acetonide (FAc) implants for the treatment of non-infectious uveitis (NIU).

Methods

A retrospective, observational study was conducted at Moorfields Eye Hospital, London, involving patients who received FAc 0.19 mg implants (Iluvien®) for NIU. 2-year follow-up data on baseline characteristics, indications, and outcomes was collected. The primary indicator for treatment failure was defined as the need for rescue treatment with dexamethasone (DEX) implants, while secondary indicators included changes in steroid and systemic immunosuppression requirements, or the need for a second FAc implant before 3 years. The occurrence of complications was collected.

Results

Of the 146 eyes treated with FAc implants, 24.0% experienced treatment failure requiring DEX implant within 2 years. About 42.9% required this within the first 6 months. There was an increase in the number of patients requiring steroids and/or systemic immunosuppression. Within the first 2 years post-FAc implant, only 13.7% experienced an IOP rise, with 4.1% requiring IOP-lowering surgery. About 57.9% of the phakic eyes developed cataracts.

Conclusion

This study provides valuable real-world evidence supporting the efficacy of FAc implant in NIU. It demonstrates a good safety profile at 2 years, with a significant reduction in uveitis recurrence rate and treatment burden. Our results are especially pertinent to the treatment of uveitic cystoid macular oedema (CMO), which was the primary indication in over 75% of our patients. Furthermore, it suggests that while FAc implant controls retinal inflammation effectively, choroidal inflammation would require alternative treatment.

KEYWORDS:

• FAc 0.19mg implant
• Iluvien® implant
• non-infectious uveitis
• ophthalmology
• uveitic macular oedema

Acknowledgments

The authors would like to acknowledge Harry Petrushkin, Colin Chu, Jose Carlo Artiaga, Rasheed Rajna, Stella Fragkopoulou, and Noha Soliman (Moorfields Eye Hospital NHS Foundation Trust).

Disclosure statement

Carlos Pavesio is a consultant for Alimera Sciences (Aldershot, Hampshire, UK), EYEVENSYS (Paris, France), Santen Pharmaceutical Co., Ltd. (Japan), and AbbVie, Inc. (North Chicago, IL, USA). The other authors report there are no competing interests to declare.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.