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依普利酮用于中心性浆液性脉络膜视网膜病变的真实世界实践模式。

Real-world practice patterns of eplerenone use for central serous chorioretinopathy.

作者信息

Venkatesh Ramesh, Prabhu Vishma, Joshi Aishwarya, Mangla Rubble, Singh Rishi, Wu Lihteh, Lanzetta Paolo, Kuppermann Baruch, Bandello Francesco, Cohen Francine Behar, Chhablani Jay

机构信息

Department of Retina and Vitreous, Narayana Nethralaya #121/C, 1st R block, Rajaji Nagar, Bangalore, 560022, India.

Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.

出版信息

Int J Retina Vitreous. 2023 Oct 2;9(1):61. doi: 10.1186/s40942-023-00500-w.

Abstract

PURPOSE

To report eplerenone use by retina specialists worldwide for central serous chorioretinopathy (CSCR).

METHODS

A self-reporting questionnaire was distributed to retina specialists worldwide to gather clinicians' perspectives on CSCR cases treated, eplerenone dosage and duration, reasons to use it, and side effects.

RESULTS

The survey included 241 retina specialists (122 Indian and 119 international) with an average experience of 15.69 ± 9.59 years. Oral eplerenone was used to treat CSCR by 149 (62%) participants. Only 6% (n = 9) had easy access to verteporfin dye and photodynamic therapy. 30 (20%) of the 149 respondents changed their treatment with eplerenone after VICI trial results. Eplerenone was prescribed mostly for chronic CSCR (n = 86, 58%), regardless of involvement laterality. 62% (n = 92) had fewer than 25% CSCR cases treated with eplerenone. 85 (57%) respondents used eplerenone only when other treatments failed, while 36 (24%) used it as first-line treatment. 73 (49%) respondents, prescribed eplerenone at a 50 mg daily dose and 137 (92%) retina specialists used eplerenone for 0-3 months. The drug's efficacy dissatisfied 21 (14%) study participants. 124 (83%) study participants did not encounter any ocular or systemic side effects with eplerenone use. Eplerenone related kidney and electrolyte issues were noted by 11 (7%) study participants.

CONCLUSION

The treatment of CSCR varies around the world and is primarily influenced by the photodynamic therapy availability and the findings of VICI trial. Despite the limited benefit of eplerenone reported by the VICI trial, it is still used as evidenced by real-world experience.

TRIAL REGISTRATION NUMBER

Not applicable.

摘要

目的

报告全球视网膜专家使用依普利酮治疗中心性浆液性脉络膜视网膜病变(CSCR)的情况。

方法

向全球视网膜专家发放一份自我报告问卷,以收集临床医生对接受治疗的CSCR病例、依普利酮剂量和疗程、使用原因及副作用的看法。

结果

该调查纳入了241名视网膜专家(122名印度专家和119名国际专家),平均从业经验为15.69±9.59年。149名(62%)参与者使用口服依普利酮治疗CSCR。只有6%(n = 9)的人能够轻松获得维替泊芬染料和光动力疗法。149名受访者中有30名(20%)在VICI试验结果公布后改变了依普利酮治疗方案。依普利酮主要用于治疗慢性CSCR(n = 86,58%),无论患侧情况如何。62%(n = 92)的人使用依普利酮治疗的CSCR病例不到25%。85名(57%)受访者仅在其他治疗失败时使用依普利酮,而36名(24%)将其作为一线治疗。73名(49%)受访者开出的依普利酮每日剂量为50毫克,137名(92%)视网膜专家使用依普利酮的时间为0至3个月。21名(14%)研究参与者对该药物的疗效不满意。124名(83%)研究参与者在使用依普利酮时未遇到任何眼部或全身副作用。11名(7%)研究参与者注意到与依普利酮相关的肾脏和电解质问题。

结论

CSCR的治疗在全球各地存在差异,主要受光动力疗法的可及性和VICI试验结果的影响。尽管VICI试验报告依普利酮的益处有限,但实际应用经验表明它仍在被使用。

试验注册号

不适用。

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