Biotherapies in Uveitis

• Published in: Journal of clinical medicine Vol. 9; no. 11; p. 3599
• Main Authors: Leclercq, Mathilde, Desbois, Anne-Claire, Domont, Fanny, Maalouf, Georgina, Touhami, Sara, Cacoub, Patrice, Bodaghi, Bahram, Saadoun, David
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 08.11.2020; MDPI
• Subjects: Arthritis; Clinical medicine; Cytokines; Disease; Drug dosages; Edema; Failure; Human health and pathology; Immunomodulators; Immunosuppressive agents; Inflammation; Life Sciences; Medical prognosis; Monoclonal antibodies; Review; Steroids; Tumor necrosis factor-TNF; Vein & artery diseases; Janus Associated Kinase (JAK) inhibitors; anti-TNF-α (anti-tumor necrosis factor alpha) agent; biotherapy; tocilizumab; non-infectious uveitis
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9113599

Non-infectious uveitis (NIU) represents one of the leading causes of blindness in developed countries. The therapeutic strategy aims to rapidly control intra-ocular inflammation, prevent irremediable ocular damage, allow corticosteroid sparing and save the vision, and has evolved over the last few years. Anterior NIU is mostly managed with topical treatment in adults. However, for intermediate, posterior and pan-uveitis, notably when both eyes are involved, systemic treatment is usually warranted. Biotherapies are recommended in case of inefficacy or non-tolerance of conventional immunosuppressive drugs in non-anterior NIU. Anti-tumor necrosis factor alpha (anti-TNF-α) agents are by far the most widely used, especially adalimumab (ADA) and infliximab (IFX). In case of sight-threatening uveitis in Behçet’s disease or in case of risk of severe recurrences, respectively IFX and ADA may be recommended as first-line therapy. Many questions are left unanswered; how long to treat NIU, how to discontinue anti-TNF-α agents, what biologic to use in case of anti-TNF-α failure? The objective of this review is to present an updated overview of knowledge on the use of biological treatments in NIU.