Recent advances in uveitis therapy: focus on selected phase 2 and 3 clinical trials

ABSTRACT

Introduction

Uveitis is a heterogeneous group of ocular conditions characterized by inflammation of the uveal tract. It is a leading cause of blindness in developed countries and exerts significant psychological, social, and economic impact on both patients and the larger society. While there are numerous pharmacotherapy options, posterior segment noninfectious uveitis remains a significant challenge to treat due to its severity, chronicity, and high recurrence rates.

Areas covered

The index review highlights the unmet needs of uveitis pharmacotherapy and its research and the shortcomings of existing ocular and systemic therapeutic options for noninfectious uveitis. The more promising novel ocular drug delivery methods and therapeutic targets/drugs are discussed, and evidence from the clinical trials is evaluated.

Expert Opinion

There has been incredible growth in the number of treatment options available to uveitis patients today, especially with the new generation of biologic drugs. Available evidence suggests that these newer options may be superior to conventional immunosuppressive therapies in terms of efficacy and side effect profiles. Further high-quality research and additional clinical trials will be needed to clarify their roles in the stepladder treatment approach of noninfectious uveitis.

KEYWORDS:

• Uveitis
• autoimmune
• noninfectious
• corticosteroids
• immunosuppression
• biologics
• small molecule inhibitor
• clinical trials

Article highlights

• Non-infectious uveitis and its complications are a significant cause of visual morbidity despite the many advancements in its treatment.

• Major unmet needs include the lack of local sustained steroid-sparing options, new systemic targeted therapeutics, and high-level evidence from well-conducted comparative trials.

• Several promising treatment options are now in various stages of development for non-infectious uveitis: novel corticosteroid formulations and delivery systems, interleukin-6 inhibitors, interleukin-17 inhibitors, Janus Kinase inhibitors.

• Selected phase 2 and phase 3 clinical trials for these new pharmacotherapeutics will be introduced and discussed.

Declaration of interest

Q D Nguyen serves as a consultant to AbbVie, Genentech, Bayer, Eyepoint, Gilead, Regeneron, and Santen. He is also a principal investigator in clinical trials involving XIPERE, OCS-1, tocilizumab, sarilumab, izokibep, filgotinib, and brepocitinib.

All other authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.