Comparative efficacy of steroid-sparing therapies for non-infectious uveitis

ABSTRACT

Introduction: Non-infectious uveitis encompasses a group of inflammatory eye diseases that can cause irreversible vision loss if left untreated or undertreated. In cases requiring systemic treatment, a step-wise treatment approach is often employed starting with corticosteroids for severe active disease, followed by initiation of steroid-sparing therapies to maintain inflammatory control and avoid the abundant complications of long-term corticosteroid use.

Areas covered: We review the current high-quality evidence comparing the efficacy of various systemic steroid-sparing agents in the treatment of non-infectious uveitis.

Expert commentary: Given the rarity of uveitis and the heterogeneity of uveitic diseases, there are few randomized controlled studies that directly compare the relative efficacy of the various steroid-sparing immunosuppressive agents. Therefore, current treatment strategies are based mainly on data from observational series.

KEYWORDS:

• Non-infectious uveitis
• immunosuppression
• methotrexate
• mycophenolate mofetil
• azathioprine
• cyclosporine
• infliximab
• adalimumab

Declaration of interest

The 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.

Additional information

Funding

This work was supported by the Intramural Research Program, National Eye Institute, National Institutes of Health.