New observations and emerging ideas in diagnosis and management of non-infectious uveitis: A review.
Adalimumab
Biologics
Corticosteroid-sparing therapy
Immune-mediated disease
Noninfectious uveitis
Journal
Seminars in arthritis and rheumatism
ISSN: 1532-866X
Titre abrégé: Semin Arthritis Rheum
Pays: United States
ID NLM: 1306053
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
05
09
2018
revised:
18
04
2019
accepted:
05
06
2019
pubmed:
16
7
2019
medline:
28
7
2020
entrez:
15
7
2019
Statut:
ppublish
Résumé
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. This review describes current and emerging therapies for NIU. 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. 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. Biologics, JAK/STAT inhibitors, and improved localized therapies may provide additional options for patients with NIU.
Sections du résumé
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.
Identifiants
pubmed: 31301816
pii: S0049-0172(18)30557-2
doi: 10.1016/j.semarthrit.2019.06.004
pii:
doi:
Substances chimiques
Biological Products
0
Glucocorticoids
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
438-445Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.