Update on the use of systemic biologic agents in the treatment of noninfectious uveitis

Sirichai Pasadhika,1 James T Rosenbaum2 1Department of Ophthalmology, Southern Arizona Veterans Administration Health Care System, Tucson, AZ, USA; 2Legacy Devers Eye Institute, Portland, OR, USA Abstract: Uveitis is one of the leading causes of blindness worldwide. Noninfectious uveitis may be as...

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Autores principales:	Pasadhika S, Rosenbaum JT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/63de8d1680dc450db1225e7363d200d2
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spelling	oai:doaj.org-article:63de8d1680dc450db1225e7363d200d22021-12-02T05:39:25ZUpdate on the use of systemic biologic agents in the treatment of noninfectious uveitis1177-5475https://doaj.org/article/63de8d1680dc450db1225e7363d200d22014-02-01T00:00:00Zhttp://www.dovepress.com/update-on-the-use-of-systemic-biologic-agents-in-the-treatment-of-noni-a15812https://doaj.org/toc/1177-5475 Sirichai Pasadhika,1 James T Rosenbaum2 1Department of Ophthalmology, Southern Arizona Veterans Administration Health Care System, Tucson, AZ, USA; 2Legacy Devers Eye Institute, Portland, OR, USA Abstract: Uveitis is one of the leading causes of blindness worldwide. Noninfectious uveitis may be associated with other systemic conditions, such as human leukocyte antigen B27-related spondyloarthropathies, inflammatory bowel disease, juvenile idiopathic arthritis, Behçet's disease, and sarcoidosis. Conventional therapy with corticosteroids and immunosuppressive agents (such as methotrexate, azathioprine, mycophenolate mofetil, and cyclosporine) may not be sufficient to control ocular inflammation or prevent non-ophthalmic complications in refractory patients. Off-label use of biologic response modifiers has been studied as primary and secondary therapeutic agents. They are very useful when conventional immunosuppressive therapy has failed or has been poorly tolerated, or to treat concomitant ophthalmic and systemic inflammation that might benefit from these medications. Biologic therapy, primarily infliximab, and adalimumab, have been shown to be rapidly effective for the treatment of various subtypes of refractory uveitis and retinal vasculitis, especially Behçet's disease-related eye conditions and the uveitis associated with juvenile idiopathic arthritis. Other agents such as golimumab, abatacept, canakinumab, gevokizumab, tocilizumab, and alemtuzumab may have great future promise for the treatment of uveitis. It has been shown that with proper monitoring, biologic therapy can significantly improve quality of life in patients with uveitis, particularly those with concurrent systemic symptoms. However, given high cost as well as the limited long-term safety data, we do not routinely recommend biologics as first-line therapy for noninfectious uveitis in most patients. These agents should be used with caution by experienced clinicians. The present work aims to provide a broad and updated review of the current and in-development systemic biologic agents for the treatment of noninfectious uveitis. Keywords: biologics, monoclonal antibody, eyePasadhika SRosenbaum JTDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2014, Iss default, Pp 67-81 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Pasadhika S Rosenbaum JT Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
description	Sirichai Pasadhika,1 James T Rosenbaum2 1Department of Ophthalmology, Southern Arizona Veterans Administration Health Care System, Tucson, AZ, USA; 2Legacy Devers Eye Institute, Portland, OR, USA Abstract: Uveitis is one of the leading causes of blindness worldwide. Noninfectious uveitis may be associated with other systemic conditions, such as human leukocyte antigen B27-related spondyloarthropathies, inflammatory bowel disease, juvenile idiopathic arthritis, Behçet's disease, and sarcoidosis. Conventional therapy with corticosteroids and immunosuppressive agents (such as methotrexate, azathioprine, mycophenolate mofetil, and cyclosporine) may not be sufficient to control ocular inflammation or prevent non-ophthalmic complications in refractory patients. Off-label use of biologic response modifiers has been studied as primary and secondary therapeutic agents. They are very useful when conventional immunosuppressive therapy has failed or has been poorly tolerated, or to treat concomitant ophthalmic and systemic inflammation that might benefit from these medications. Biologic therapy, primarily infliximab, and adalimumab, have been shown to be rapidly effective for the treatment of various subtypes of refractory uveitis and retinal vasculitis, especially Behçet's disease-related eye conditions and the uveitis associated with juvenile idiopathic arthritis. Other agents such as golimumab, abatacept, canakinumab, gevokizumab, tocilizumab, and alemtuzumab may have great future promise for the treatment of uveitis. It has been shown that with proper monitoring, biologic therapy can significantly improve quality of life in patients with uveitis, particularly those with concurrent systemic symptoms. However, given high cost as well as the limited long-term safety data, we do not routinely recommend biologics as first-line therapy for noninfectious uveitis in most patients. These agents should be used with caution by experienced clinicians. The present work aims to provide a broad and updated review of the current and in-development systemic biologic agents for the treatment of noninfectious uveitis. Keywords: biologics, monoclonal antibody, eye
format	article
author	Pasadhika S Rosenbaum JT
author_facet	Pasadhika S Rosenbaum JT
author_sort	Pasadhika S
title	Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
title_short	Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
title_full	Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
title_fullStr	Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
title_full_unstemmed	Update on the use of systemic biologic agents in the treatment of noninfectious uveitis
title_sort	update on the use of systemic biologic agents in the treatment of noninfectious uveitis
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/63de8d1680dc450db1225e7363d200d2
work_keys_str_mv	AT pasadhikas updateontheuseofsystemicbiologicagentsinthetreatmentofnoninfectiousuveitis AT rosenbaumjt updateontheuseofsystemicbiologicagentsinthetreatmentofnoninfectiousuveitis
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Update on the use of systemic biologic agents in the treatment of noninfectious uveitis

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