Risk factors for adverse events or use of high-potency corticosteroids in non-infectious uveitis: a Japan claims database study (J-CAT2).

The J-CAT2 study (#jRCT1030240195) aimed to evaluate treatment and patient factors associated with risk of complications/adverse events (AEs) or high corticosteroid exposure in patients with non-infectious uveitis (NIU) using advanced quantitative and visual analytical approaches. The study included data from a nationwide insurance claims database in Japan. Patients with NIU treatment-related claims (2016-2023) were included (n = 98,842). A nested case-control design was used to evaluate patient factors associated with complications/AEs or high corticosteroid exposure. Multivariable logistic regression and decision-tree analyses were performed. Sub-Tenon's corticosteroid injections were associated with dose-dependent increased odds of glaucoma treatment and cataract surgery (OR [95% CI]: 1 sub-Tenon's injection, 3.27 [2.60-4.11] and 3.19 [2.39-4.27], respectively; ≥2 sub-Tenon's injections, 5.54 [4.03-7.60] and 4.86 [3.44-6.85], respectively). Macular edema was the most likely factor associated with ≥2 sub-Tenon injections. Vogt-Koyanagi-Harada disease and sarcoidosis were the most likely factors associated with medium-to-high-dose corticosteroids and long-term oral corticosteroids. The J-CAT2 study used a novel, quantitative and visual framework to understand associations between dose, frequency, and duration of corticosteroid treatment and complications/AE risk in NIU. These findings suggest that optimization of corticosteroid administration protocols and exploration of alternative therapeutic strategies/targeted treatment approaches are necessary to mitigate complication risks.