Progress in the understanding and utilization of biologic response modifiers in the treatment of uveitis

ABSTRACT

Uveitis is the third most common cause of blindness in developed countries. Considering the systemic and local complications of long-term corticosteroid therapy and the intolerance due to side effects and ineffectiveness of conventional chemotherapy, use of biologic response modifiers is a reasonable alternative in the treatment of non-infectious uveitis and persistent uveitic macular edema. The majority of the evidence presented here comes from open uncontrolled analyses. Based on these studies, tumor necrosis factor alpha inhibitors, especially infliximab and adalimumab, have been shown to be effective in the treatment of non-infectious uveitis in numerous studies. More research is necessary, particularly multi-center randomized clinical trials, to address the choice of biologic response modifier agent and the length of treatment as we employ biologic response modifiers in different types of uveitis and persistent uveitic macular edema.

KEYWORDS:

• Biologic response modifiers
• TNF-alpha inhibitors
• B-lymphocyte inhibitor
• T-lymphocyte inhibitor
• pan lymphocyte inhibitor
• specific receptor antagonists
• interferon
• immunomodulatory therapy
• steroid-free remission

Declaration of interest

S Foster declares the following: consultancies with Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA), Eyegate Pharma (Waltham, MA), Novartis (Cambridge, MA), pSivida (Watertown, MA), and Xoma (Berkeley, CA); grants or grants pending with Alcon (Aliso Viejo, CA), Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb (Bridgewater, NJ), Clearside Biomedical (Alpharetta, GA), Dompé pharmaceutical (Milan, Italy), Eyegate Pharma (Waltham, MA), Mallinckrodt pharmaceuticals (Dublin, Ireland), Novartis Pharmaceuticals (Cambridge, MA), pSivida (Watertown, MA), Santen (Osaka, Japan); payment for lectures including service on speaking bureaus for Alcon (Aliso Viejo, CA), Allergan (Dublin, Ireland); stock or stock options for Eyegate Pharma (Waltham, MA). The authors have no other 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 apart from those disclosed.