One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis; however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.
References
[1]
Dick, A.D., Rosenbaum, T., Al-Dhibi, H.A., et al. (2018) Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals of Care for UveitiS (FOCUS) Initiative. Ophthalmology, 125, 757-773. https://doi.org/10.1016/j.ophtha.2017.11.017
[2]
Rosenbaum, J.T., Bodaghi, B., Couto, C., et al. (2019) New Observations and Emerging Ideas in Diagnosis and Management of Non-Infectious Uveitis: A Review. Seminars in Arthritis and Rheumatism, 49, 438-445. https://doi.org/10.1016/j.semarthrit.2019.06.004
[3]
Modugno, R.L., Testi, I. and Pavesio, C. (2021) Intraocular Therapy in Noninfectious Uveitis. Journal of Ophthalmic Inflammation and Infection, 11, Article No. 37. https://doi.org/10.1186/s12348-021-00267-x
[4]
Cabahug, V.L.O., Uy, H.S., Yu-Keh, E. and Sapno, K.J.D. (2019) Outcomes of Treatment with Sirolimus for Non-Infectious Uveitis: A Meta-Analysis and Systematic Review. Clinical Ophthalmology, 13, 649-669. https://doi.org/10.2147/OPTH.S198401
[5]
Nguyen, A.T., Kone-Paut, I. and Dusser, P. (2023) Diagnosis and Management of Non-Infectious Uveitis in Pediatric Patients. Paediatric Drugs, 26, 31-47. https://doi.org/10.1007/s40272-023-00596-5
[6]
Balasubramaniam, B., Chong, Y., Azzopardi, M., et al. (2022) Topical Anti-Inflammatory Agents for Non-Infectious Uveitis: Current Treatment and Perspectives. Journal of Inflammation Research, 15, 6439-6451.
[7]
Hart, C.T. and Zhu, E.Y. (2019) Epidemiology of Uveitis in Urban Australia. Clinical & Experimental Ophthalmology, 47, 733-740. https://doi.org/10.1111/ceo.13517
[8]
Hsu, Y.R., Huang, J.C., Tao, Y., et al. (2019) Noninfectious Uveitis in the Asia-Pacific Region. Eye, 33, 66-77. https://doi.org/10.1038/s41433-018-0223-z
[9]
Kalogeropoulos, D., Asproudis, I., Stefaniotou, M., et al. (2023) The Large Hellenic Study of Uveitis: Epidemiology, Etiologic Factors and Classification. International Ophthalmology, 43, 3633-3650. https://doi.org/10.1007/s10792-023-02772-5
[10]
Garcia-Aparicio, A., de Yébenes, M.J.G., Oton, T. and Munoz-Fernandez, S. (2021) Prevalence and Incidence of Uveitis: A Systematic Review and Meta-Analysis. Ophthalmic Epidemiology, 28, 461-468. https://doi.org/10.1080/09286586.2021.1882506
[11]
Joltikov, K.A. and Lobo-Chan, A.M. (2021) Epidemiology and Risk Factors in Non-Infectious Uveitis: A Systematic Review. Frontiers in Medicine, 8, Article 695904.
[12]
Tsirouki, T., Dastiridou, A., Symeonidis, C., et al. (2018) A Focus on the Epidemiology of Uveitis. Ocular Immunology and Inflammation, 26, 2-16. https://doi.org/10.1080/09273948.2016.1196713
[13]
The Standardization of Uveitis Nomenclature (SUN) Working Group (2021) Classification Criteria for Vogt-Koyanagi-Harada Disease. American Journal of Ophthalmology, 228, 205-211. https://doi.org/10.1016/j.ajo.2021.03.036
[14]
Valdes, L.M. and Sobrin, L. (2020) Uveitis Therapy: The Corticosteroid Options. Drugs, 80, 765-773. https://doi.org/10.1007/s40265-020-01314-y
[15]
Hassan, M., Karkhur, S., Bae, J.H., et al. (2019) New Therapies in Development for the Management of Non-Infectious Uveitis: A Review. Clinical & Experimental Ophthalmology, 47, 396-417. https://doi.org/10.1111/ceo.13511
[16]
Sheppard, J.D., Foster, C.S., Toyos, M.M., et al. (2019) Difluprednate 0.05% versus Prednisolone Acetate 1% for Endogenous Anterior Uveitis: Pooled Efficacy Analysis of Two Phase 3 Studies. Ocular Immunology and Inflammation, 27, 484-496. https://doi.org/10.1080/09273948.2017.1407433
[17]
Thomas, A.S. and Lin, P. (2020) Local Treatment of Infectious and Noninfectious Intermediate, Posterior, and Panuveitis: Current Concepts and Emerging Therapeutics. Current Opinion in Ophthalmology, 31, 174-184. https://doi.org/10.1097/ICU.0000000000000651
[18]
Mckay, K.M., Borkar, D.S., Sevgi, D.D., et al. (2021) Comparison of Modified Posterior Sub-Tenon’s vs. Trans-Septal Triamcinolone Injection for Non-Infectious Uveitis. Ocular Immunology and Inflammation, 29, 857-864. https://doi.org/10.1080/09273948.2019.1698748
[19]
Jung, J.L., Harasawa, M., Patnaik, J.L., et al. (2022) Subtenon Triamcinolone Acetonide Injection with Topical Anesthesia in Pediatric Non-Infectious Uveitis. Ophthalmology and Therapy, 11, 811-820. https://doi.org/10.1007/s40123-022-00480-4
[20]
Park, U.C., Park, J.H. and Yu, H.G. (2014) Long-Term Outcome of Intravitreal Triamcinolone Acetonide Injection for the Treatment of Uveitis Attacks in Behcet Disease. Ocular Immunology and Inflammation, 22, 27-33. https://doi.org/10.3109/09273948.2013.829109
[21]
Ganapathy, P.S., Lowder, C.Y., Arepalli, S., et al. (2018) Treatment Duration and Side Effect Profile of Long-Term Use of Intravitreal Preservative-Free Triamcinolone Acetonide in Uveitis. American Journal of Ophthalmology, 194, 63-71. https://doi.org/10.1016/j.ajo.2018.07.003
[22]
Shahab, M.A., Mir, T.A. and Zafar, S. (2019) Optimising Drug Therapy for Non-Infectious Uveitis. International Ophthalmology, 39, 1633-1650. https://doi.org/10.1007/s10792-018-0984-1
[23]
Bodaghi, B., Brézin, A.P., et al. (2022) Real-Life Efficacy, Safety, and Use of Dexamethasone Intravitreal Implant in Posterior Segment Inflammation Due to Non-Infectious Uveitis (LOUVRE 2 Study). Ophthalmology and Therapy, 11, 1775-1792. https://doi.org/10.1007/s40123-022-00525-8
[24]
Iarossi, G. and Copp, A.M. (2022) Dexamethasone Intravitreal Implant (Ozurdex) in Paediatric Patients with Non-Infectious Intermediate Uveitis and Related Cystoid Macular Oedema: Evaluation of Macular Morphology and Function with Six-Month Follow-Up; A Deeper Role of MfERG? Ocular Immunology and Inflammation, 30, 234-240. https://doi.org/10.1080/09273948.2020.1794011
[25]
Kempen, J.H., Altaweel, M.M., Drye, L.T., et al. (2015) Benefits of Systemic Anti-Inflammatory Therapy versus Fluocinolone Acetonide Intraocular Implant for Intermediate Uveitis, Posterior Uveitis, and Panuveitis: Fifty-Four-Month Results of the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-Up Study. Ophthalmology, 122, 1967-1975. https://doi.org/10.1016/j.ophtha.2015.06.042
[26]
Leinonen, S., Immonen, I. and Kotaniemi, K. (2018) Fluocinolone Acetonide Intravitreal Implant (Retisert®) in the Treatment of Sight-Threatening Macular Oedema of Juvenile Idiopathic Arthritis-Related Uveitis. Acta Ophthalmologica, 96, 648-651. https://doi.org/10.1111/aos.13744
[27]
Testi, I. and Pavesio, C. (2019) Preliminary Evaluation of YUTIQTM (Fluocinolone Acetonide Intravitreal Implant 0.18 mg) in Posterior Uveitis. Therapeutic Delivery, 10, 621-625. https://doi.org/10.4155/tde-2019-0051
[28]
Babel, A.T. and Chin, E.K. (2022) Long-Acting Fluocinolone Acetonide Intravitreal Implant for Recurrent Bilateral Non-Infectious Posterior Uveitis. International Medical Case Reports Journal, 15, 665-669. https://doi.org/10.2147/IMCRJ.S384356
[29]
Reddy, A.K., Pecen, P.E., Patnaik, J.L. and Palestine, A.G. (2023) Single Institution Experience of Intravitreal 0.18-Mg Fluocinolone Acetonide Implant for Noninfectious Uveitis. Ophthalmology Retina, 7, 67-71. https://doi.org/10.1016/j.oret.2022.07.002
[30]
Weber, L.F., Marx, S., Auffarth, G.U., et al. (2019) Injectable 0.19-Mg Fluocinolone Acetonide Intravitreal Implant for the Treatment of Non-Infectious Uveitic Macular Edema. Journal of Ophthalmic Inflammation and Infection, 9, Article No. 3. https://doi.org/10.1186/s12348-019-0168-9
[31]
Hikal, M., Celik, N. and Auffarth, G.U. (2021) Intravitreal 0.19 Mg Fluocinolone Acetonide Implant in Non-Infectious Uveitis. Journal of Clinical Medicine, 10, Article 3966. https://doi.org/10.3390/jcm10173966
[32]
Studsgaard, A., Clemmensen, K. and Nielsen, M.S. (2022) Intravitreal Fluocinolone Acetonide 0.19 mg (Iluvien®) for the Treatment of Uveitic Macular Edema: 2-Year Follow-Up of 20 Patients. Graefe’s Archive for Clinical and Experimental Ophthalmology, 260, 1633-1639. https://doi.org/10.1007/s00417-021-05504-6
[33]
Fung, S. and Syed, Y.Y. (2022) Suprachoroidal Space Triamcinolone Acetonide: A Review in Uveitic Macular Edema. Drugs, 82, 1411. https://doi.org/10.1007/s40265-022-01777-1
[34]
Barakat, M.R., Wykoff, C.C., Gonzalez, V., et al. (2021) Suprachoroidal CLS-TA plus Intravitreal Aflibercept for Diabetic Macular Edema: A Randomized, Double-Masked, Parallel-Design, Controlled Study. Ophthalmology Retina, 5, 60-70. https://doi.org/10.1016/j.oret.2020.08.007
[35]
Yeh, S., Khurana, R.N., Shah, M., et al. (2020) Efficacy and Safety of Suprachoroidal CLS-TA for Macular Edema Secondary to Noninfectious Uveitis: Phase 3 Randomized Trial. Ophthalmology, 127, 948-955. https://doi.org/10.1016/j.ophtha.2020.01.006
[36]
Henry, C.R., Shah, M., Barakat, M.R., et al. (2022) Suprachoroidal CLS-TA for Non-Infectious Uveitis: An Open-Label, Safety Trial (AZALEA). British Journal of Ophthalmology, 106, 802-806. https://doi.org/10.1136/bjophthalmol-2020-318019
[37]
Agrawal, H., Doan, H., Pham, B., et al. (2020) Systemic Immunosuppressive Therapies for Uveitis in Developing Countries. Indian Journal of Ophthalmology, 68, 1852-1862. https://doi.org/10.4103/ijo.IJO_1548_20
[38]
Mcharg, M., Young, L., Kesav, N., et al. (2022) Practice Patterns Regarding Regional Corticosteroid Treatment in Noninfectious Uveitis: A Survey Study. Journal of Ophthalmic Inflammation and Infection, 12, Article No. 3. https://doi.org/10.1186/s12348-021-00281-z
[39]
Ormaechea, M.S., Hassan, M., Onghanseng, N., et al. (2019) Safety of Systemic Therapy for Noninfectious Uveitis. Expert Opinion on Drug Safety, 18, 1219-1235. https://doi.org/10.1080/14740338.2019.1692810
[40]
Arepalli, S. and Rosenbaum, J.T. (2019) The Use of Biologics for Uveitis Associated with Spondyloarthritis. Current Opinion in Rheumatology, 31, 349-354. https://doi.org/10.1097/BOR.0000000000000619
[41]
Leone, G.M. and Mangano, K. (2023) Past, Present and (Foreseeable) Future of Biological Anti-TNF α Therapy. Journal of Clinical Medicine, 12, Article 1630. https://doi.org/10.3390/jcm12041630
[42]
Jang, D.I. and Lee, A.H. (2021) The Role of Tumor Necrosis Factor α (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics. International Journal of Molecular Sciences, 22, Article 2719. https://doi.org/10.3390/ijms22052719
[43]
Hasan, N. and Chawla, R. (2022) A Comprehensive Review of Intravitreal Immunosuppressants and Biologicals Used in Ophthalmology. Therapeutic Advances in Ophthalmology, 14. https://doi.org/10.1177/25158414221097418
[44]
Valdes, L., Cox, J.T., Yang, J., et al. (2022) Anti-Infliximab Antibodies and Clinical Response in Noninfectious Uveitis and Scleritis Patients Treated with Infliximab: A Retrospective Review. American Journal of Ophthalmology Case Reports, 27, Article ID: 101634. https://doi.org/10.1016/j.ajoc.2022.101634
[45]
Takeuchi, M., Usui, Y., Namba, K., et al. (2023) Ten-Year Follow-Up of Infliximab Treatment for Uveitis in Behcet Disease Patients: A Multicenter Retrospective Study. Frontiers in Medicine, 10, Article 1095423. https://doi.org/10.3389/fmed.2023.1095423
[46]
Refaat, M., Abdullatif, A.M., Hamza, M.M., et al. (2021) Monthly Intravitreal Infliximab in Behcet’s Disease Active Posterior Uveitis: A Long-Term Safety Study. Retina, 41, 1739-1747. https://doi.org/10.1097/IAE.0000000000003095
[47]
Maccora, I., Dell’Anna, M.P., Vannacci, A. and Simonini, G. (2020) Safety Evaluations of Adalimumab for Childhood Chronic Rheumatic Diseases. Expert Opinion on Drug Safety, 19, 661-671. https://doi.org/10.1080/14740338.2020.1763300
[48]
Burek-Michalska, A. and Turno-Krecicka, A. (2020) Adalimumab in the Treatment of Non-Infectious Uveitis. Advances in Clinical and Experimental Medicine, 29, 1231-1236. https://doi.org/10.17219/acem/125431
[49]
Goto, H., Zako, M., Namba, K., et al. (2019) Adalimumab in Active and Inactive, Non-Infectious Uveitis: Global Results from the VISUAL I and VISUAL II Trials. Ocular Immunology and Inflammation, 27, 40-50. https://doi.org/10.1080/09273948.2018.1491605
[50]
Namba, K., Kaburaki, T., Tsuruga, H., et al. (2022) Long-Term Safety and Effectiveness of Adalimumab in Japanese Patients with Noninfectious Intermediate, Posterior, or Panuveitis: Post-Marketing Surveillance of 251 Patients. Ophthalmology and Therapy, 11, 1147-1161. https://doi.org/10.1007/s40123-022-00493-z
[51]
Wu, X., Tao, M., Zhu, L., et al. (2023) Pathogenesis and Current Therapies for Non-Infectious Uveitis. Clinical and Experimental Medicine, 23, 1089-1106. https://doi.org/10.1007/s10238-022-00954-6
[52]
Kim, M., Won, J.Y., Choi, S.Y., et al. (2016) Anti-TNFα Treatment for HLA-B27-Positive Ankylosing Spondylitis-Related Uveitis. American Journal of Ophthalmology, 170, 32-40. https://doi.org/10.1016/j.ajo.2016.07.016
[53]
Van Bentum, R.E., Heslinga, S.C., Nurmohamed, M.T., et al. (2019) Reduced Occurrence Rate of Acute Anterior Uveitis in Ankylosing Spondylitis Treated with Golimumab—The GO-EASY Study. The Journal of Rheumatology, 46, 153-159. https://doi.org/10.3899/jrheum.180312
[54]
Lanz, S., Seidel, G. and Skrabl-Baumgartner, A. (2021) Golimumab in Juvenile Idiopathic Arthritis-Associated Uveitis Unresponsive to Adalimumab. Pediatric Rheumatology, 19, Article No. 132. https://doi.org/10.1186/s12969-021-00630-1
[55]
Weigelt, C.M., Zippel, N., Fuchs, H., et al. (2022) Characterization and Validation of in Vitro and in Vivo Models to Investigate TNF-α-Induced Inflammation in Retinal Diseases. Translational Vision Science & Technology, 11, Article 18. https://doi.org/10.1167/tvst.11.5.18
[56]
Sharon, Y. and Chu, D.S. (2020) Certolizumab Pegol—Tumor Necrosis Factor Inhibitor for Refractory Uveitis. American Journal of Ophthalmology Case Reports, 18, Article ID: 100633. https://doi.org/10.1016/j.ajoc.2020.100633
[57]
Martín-Varillas, J.L., Sanchez-Bilbao, L., Calvo-Río, V., et al. (2022) Long-Term Follow-Up of Certolizumab Pegol in Uveitis Due to Immune-Mediated Inflammatory Diseases: Multicentre Study of 80 Patients. RMD Open, 8, e002693. https://doi.org/10.1136/rmdopen-2022-002693
[58]
Shettle, L., Mclaurin, E., et al. (2022) Topical Anti-TNFα Agent Licaminlimab (OCS-02) Relieves Persistent Ocular Discomfort in Severe Dry Eye Disease: A Randomized Phase II Study. Clinical Ophthalmology, 16, 2167-2177. https://doi.org/10.2147/OPTH.S366836
[59]
Pasquali, T.A., Toyos, M.M., Abrams, D.B., et al. (2022) Topical Ocular Anti-TNFα Agent Licaminlimab in the Treatment of Acute Anterior Uveitis: A Randomized Phase II Pilot Study. Translational Vision Science & Technology, 11, Article 14. https://doi.org/10.1167/tvst.11.6.14
[60]
Ng, C.C., Sy, A. and Cunningham Jr., E.T. (2021) Rituximab for Non-Infectious Uveitis and Scleritis. Journal of Ophthalmic Inflammation and Infection, 11, Article No. 23. https://doi.org/10.1186/s12348-021-00252-4
[61]
Zhu, L., Chen, B. and Su, W. (2021) A Review of the Various Roles and Participation Levels of B-Cells in Non-Infectious Uveitis. Frontiers in Immunology, 12, Article 676046. https://doi.org/10.3389/fimmu.2021.676046
[62]
Bolletta, E., Gozzi, F., Mastrofilippo, V., et al. (2022) Efficacy of Rituximab Treatment in Vogt-Koyanagi-Harada Disease Poorly Controlled by Traditional Immunosuppressive Treatment. Ocular Immunology and Inflammation, 30, 1303-1308. https://doi.org/10.1080/09273948.2021.1880604
[63]
Vicente-Rabaneda, E.F., Atienza-Mateo, B., Blanco, R., et al. (2021) Efficacy and Safety of Abatacept in Interstitial Lung Disease of Rheumatoid Arthritis: A Systematic Literature Review. Autoimmunity Reviews, 20, Article ID: 102830. https://doi.org/10.1016/j.autrev.2021.102830
[64]
Heiligenhaus, A., Minden, K., Tappeiner, C., et al. (2019) Update of the Evidence Based, Interdisciplinary Guideline for Anti-Inflammatory Treatment of Uveitis Associated with Juvenile Idiopathic Arthritis. Seminars in Arthritis and Rheumatism, 49, 43-55. https://doi.org/10.1016/j.semarthrit.2018.11.004
[65]
Birolo, C., Zannin, M.E., Arsenyeva, S., et al. (2016) Comparable Efficacy of Abatacept Used as First-Line or Second-Line Biological Agent for Severe Juvenile Idiopathic Arthritis-Related Uveitis. The Journal of Rheumatology, 43, 2068-2073. https://doi.org/10.3899/jrheum.151389
[66]
Dipasquale, V., Atteritano, M., Fresta, J., et al. (2019) Tocilizumab for Refractory Uveitis Associated with Juvenile Idiopathic Arthritis: A Report of Two Cases. Journal of Clinical Pharmacy and Therapeutics, 44, 482-485. https://doi.org/10.1111/jcpt.12821
[67]
Vegas-Revenga, N., Calvo-Río, O.V., Mesquida, M., et al. (2019) Anti-IL6-Receptor Tocilizumab in Refractory and Noninfectious Uveitic Cystoid Macular Edema: Multicenter Study of 25 Patients. American Journal of Ophthalmology, 200, 85-94. https://doi.org/10.1016/j.ajo.2018.12.019
[68]
Wennink, R.A.W., Ayuso, V.K., De Vries, L.A., et al. (2021) Tocilizumab as an Effective Treatment Option in Children with Refractory Intermediate and Panuveitis. Ocular Immunology and Inflammation, 29, 21-25. https://doi.org/10.1080/09273948.2020.1712431
[69]
Maccora, I., Abu Rumeileh, S., Curci, F., et al. (2022) Tocilizumab and Abatacept for the Treatment of Childhood Chronic Uveitis: A Monocentric Comparison Experience. Frontiers in Pediatrics, 10, Article 851453. https://doi.org/10.3389/fped.2022.851453
[70]
Sanford, M. and Mckeage, K. (2015) Secukinumab: First Global Approval. Drugs, 75, 329-338. https://doi.org/10.1007/s40265-015-0359-0
[71]
Deodhar, A.A., Miceli-Richard, C., Baraliakos, X., et al. (2020) Incidence of Uveitis in Secukinumab-Treated Patients with Ankylosing Spondylitis: Pooled Data Analysis from Three Phase 3 Studies. ACR Open Rheumatology, 2, 294-299. https://doi.org/10.1002/acr2.11139
[72]
Lu, J.J., Tang, S., Yu, N., et al. (2020) Successful Secukinumab Treatment of Erythrodermic Psoriasis and Psoriatic Arthritis Concomitant with Severe Noninfectious Uveitis: A Case Report. Journal of International Medical Research, 48. https://doi.org/10.1177/0300060520969494