Suprachoroidal triamcinolone acetonide injectable suspension for macular edema associated with uveitis: Effect of disease characteristics on clinical outcomes

Abstract

Purpose : Triamcinolone acetonide injectable suspension, for suprachoroidal use (SCS-TA) provides targeted drug delivery to the choroid/retina while minimizing steroid exposure in nontarget tissues. Efficacy and safety of SCS-TA in the treatment of macular edema (ME) secondary to noninfectious uveitis (NIU) were demonstrated in PEACHTREE. The objective of these post-hoc analyses was to determine whether baseline disease characteristics impact the efficacy of SCS-TA.

Methods : In PEACHTREE, 96 subjects received SCS-TA at baseline and Week 12; best-corrected visual acuity (BCVA) and central subfield thickness (CST; in µm) were evaluated every 4 weeks for 24 weeks. Mean [SEM] change from baseline (CFB) in BCVA (ETDRS letters) and CST (µm) were calculated among SCS-TA-treated subjects by time since ME diagnosis (n=24 ≤71 days, n=22 >71 days) or NIU diagnosis (n=60 ≤177 days, n=36 >177 days), and by disease onset (n=22 sudden, n=74 insidious) or duration (n=18 ≤3 months, n=78 >3 months). Treatment differences were evaluated using an analysis of variance model with a fixed effect for baseline demographic factors.

Results : Significant BCVA gains and CST reductions from baseline were found in all groups at all visits irrespective of time to diagnosis or disease onset/duration (P≤0.05). At Week 24, BCVA gains were 15.5 [1.48] in subjects with ME diagnosis ≤71 days vs 8.0 [3.37] in those with diagnosis >71 days (P=0.024) and 19.6 [3.13] in subjects with NIU duration ≤3 months vs 12.4 (1.55] with NIU >3 months (P=0.048). In subjects with NIU diagnosis ≤177 days vs >177 days and sudden vs insidious disease duration BCVA gains were 15.5 [1.70] vs 10.8 [2.42] and 18.4 [3.09] vs 12.4 [1.56], respectively at Week 24 (P≥0.075). In subjects with more recent vs earlier ME/NIU diagnoses, changes in CST were -164.2 [20.15] vs -115.3 [24.27] and -163.7 [23.28] vs -133.4 [20.15], while those with sudden vs insidious onset and NIU duration ≤3 vs >3 months had CST values of -165.7 [38.50] vs -148.8 [18.25] and -166.3 [45.29] vs -149.3 [17.49], respectively (P≥0.210).

Conclusions : Significant improvements in BCVA and CST were observed regardless of baseline disease characteristics, with trends towards greater improvements in those with more recent diagnosis and shorter disease duration. These findings suggest that treatment should be initiated promptly upon diagnosis.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.