a Analysis Group Inc. , Boston , MA , USA.
b Mallinckrodt Pharmaceuticals , Bedminster , NJ , USA.
Curr Med Res Opin. 2018 Dec;34(12):2095-2103. doi: 10.1080/03007995.2018.1512961. Epub 2018 Sep 5.
Non-infectious inflammatory eye diseases (IEDs), although rare, are complex and varied and may result in detrimental effects. A systematic literature review was conducted on the clinical outcome and economic burden of IED.
The Ovid search platform (Wolters Kluwer) was used to access scientific literature databases, including MEDLINE, Embase, Cochrane libraries, Health Technology Assessment and the NHS Economic Evaluation database. The search strategy targeted clinical and economic outcomes research in 2009-2016. Titles and abstracts resulting from inclusion criteria were screened, and two reviewers independently extracted relevant information from the selected full-text articles.
Thirty-nine papers met the inclusion criteria - 21 clinical trials, 7 database analyses, 6 non-systematic literature reviews with expert commentary, 3 chart reviews, and 2 surveys - which assessed steroids, immunosuppressants, implants and biologics. Patients experienced considerable morbidity, much of which was associated with corticosteroid use. The average annual healthcare costs of patients with IED were $13,728 to $32,268 in 2009 US dollars, which amounted to 3.1 to 8.3 times that of patients without IED. Steroid-releasing intraocular implants were associated with higher up-front costs, close monitoring requirements, potential for implant removal and increased rates of adverse ocular events than systemic steroids.
IEDs are rare and complex conditions that threaten eyesight and impose considerable morbidity as well as a substantial economic burden. This review confirms that further research is needed to more fully explore the burden of IED and treatment-related adverse events, as well as appropriate means for clinicians to intensify treatment.
非传染性炎性眼病（IED）虽然罕见，但较为复杂且种类繁多，可能产生有害影响。对 IED 的临床结局和经济负担进行了系统文献回顾。
利用 Ovid 检索平台（威科集团）检索了科学文献数据库，包括 MEDLINE、Embase、考科蓝图书馆、卫生技术评估和英国国家卫生服务经济评价数据库。检索策略针对 2009-2016 年的临床结局和经济评价研究。根据纳入标准筛选标题和摘要，两名审查员独立从选定的全文文章中提取相关信息。
有 39 篇论文符合纳入标准——21 项临床试验、7 项数据库分析、6 项非系统性文献综述和专家评论、3 项图表回顾和 2 项调查，评估了类固醇、免疫抑制剂、植入物和生物制剂。患者经历了相当大的发病率，其中大部分与皮质类固醇的使用有关。2009 年，患有 IED 的患者的平均年医疗保健费用为 13728 至 32268 美元，是无 IED 患者的 3.1 至 8.3 倍。与全身使用类固醇相比，皮质类固醇释放型眼内植入物具有更高的前期成本、更密切的监测要求、潜在的植入物移除以及更高的眼部不良事件发生率。
IED 是罕见且复杂的疾病，会威胁视力，导致严重的发病率和巨大的经济负担。本综述证实，需要进一步研究以更全面地探讨 IED 的负担以及与治疗相关的不良事件，以及临床医生加强治疗的适当方法。
