James T Rosenbaum1, Bahram Bodaghi2, Cristobal Couto3, Manfred Zierhut4, Nisha Acharya5, Carlos Pavesio6, Mei-Ling Tay-Kearney7, Piergiorgio Neri8, Kevin Douglas9, Sophia Pathai10, Alexandra P Song11, Martina Kron12, C Stephen Foster13. 1. Department of Ophthalmology and Medicine, Oregon Health and Sciences University, Portland, OR, United States; Legacy Devers Eye Institute, Portland, OR, United States. Electronic address: jtrosenb@lhs.org. 2. Department of Ophthalmology, Sorbonne University DHU ViewRestore, AP-HP, Paris, France. 3. Uveitis, Retina and Cornea Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina. 4. Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany. 5. Francis I. Proctor Foundation and Department of Ophthalmology and Epidemiology, University of California, San Francisco, CA, United States. 6. Moorfields Eye Hospital and Biomedical Research Center, NHS Foundation Trust, London, United Kingdom. 7. Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia. 8. The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. 9. AbbVie Inc., North Chicago, IL, United States. 10. AbbVie Ltd, Maidenhead, United Kingdom. 11. AbbVie Deutschland GmbH & Co. KG, Knollstraße 67061 Ludwigshafen, Germany. 12. Massachusetts Eye Research and Surgery Institution, Waltham, MA, United States. 13. Ocular Immunology and Uveitis Foundation, Waltham, MA, United States; Harvard Medical School, Boston, MA, United States.
Abstract
BACKGROUND: Non-infectious uveitis (NIU) is an immune-mediated disease with clinical symptoms such as eye pain, redness, floaters, and light sensitivity. NIU is one of the leading causes of preventable blindness. OBJECTIVE: This review describes current and emerging therapies for NIU. METHODS: PubMed searches were conducted using the terms uveitis, therapy, corticosteroids, immunomodulators, biologics, intravitreal injections, intraocular implants, and adverse events deemed relevant if they presented data relating to prevalence, diagnosis, and treatment of uveitis. RESULTS: Diagnosis and management of NIU may require collaboration among different healthcare providers, including ophthalmologists and rheumatologists. Although many patients with NIU respond to corticosteroid (CS) therapy, long-term CS use can be associated with potentially severe adverse events. Localized CS therapies have been developed to reduce adverse events; however, some intravitreal injections and intraocular implants were linked to elevated intraocular pressure and cataracts. CS-sparing therapies such as biologics have demonstrated efficacy and safety while reducing CS burden. Biologics targeting tumor necrosis factor provide CS-sparing options for patients with NIU. Additional studies are needed to address long-term efficacy and safety of biologics targeting IL-6 and inhibitors of JAK/STAT. CONCLUSION: Biologics, JAK/STAT inhibitors, and improved localized therapies may provide additional options for patients with NIU.
BACKGROUND:Non-infectious uveitis (NIU) is an immune-mediated disease with clinical symptoms such as eye pain, redness, floaters, and light sensitivity. NIU is one of the leading causes of preventable blindness. OBJECTIVE: This review describes current and emerging therapies for NIU. METHODS: PubMed searches were conducted using the terms uveitis, therapy, corticosteroids, immunomodulators, biologics, intravitreal injections, intraocular implants, and adverse events deemed relevant if they presented data relating to prevalence, diagnosis, and treatment of uveitis. RESULTS: Diagnosis and management of NIU may require collaboration among different healthcare providers, including ophthalmologists and rheumatologists. Although many patients with NIU respond to corticosteroid (CS) therapy, long-term CS use can be associated with potentially severe adverse events. Localized CS therapies have been developed to reduce adverse events; however, some intravitreal injections and intraocular implants were linked to elevated intraocular pressure and cataracts. CS-sparing therapies such as biologics have demonstrated efficacy and safety while reducing CS burden. Biologics targeting tumornecrosis factor provide CS-sparing options for patients with NIU. Additional studies are needed to address long-term efficacy and safety of biologics targeting IL-6 and inhibitors of JAK/STAT. CONCLUSION: Biologics, JAK/STAT inhibitors, and improved localized therapies may provide additional options for patients with NIU.
Authors: Libei Zhao; Manqiang Peng; Wenxiang Lin; Qian Tan; Muhammad Ahmad Khan; Ding Lin Journal: Drug Des Devel Ther Date: 2020-08-20 Impact factor: 4.162
Authors: Seenu M Hariprasad; George Joseph; Patrick Gagnon-Sanschagrin; Elizabeth Serra; Subrata Bhattacharyya; Jérôme Bédard; Annie Guérin; Thomas Arno Albini Journal: BMJ Open Ophthalmol Date: 2021-11-10